Gastric cancer (GC) is one of the major malignant diseases worldwide, especially in Asia, where Japan and Korea have the highest incidence in the world. Gastric cancer is classified into intestinal and diffuse types. While the former is almost absolutely caused by Helicobacter pylori infection as the initial insult, the latter seems to include cases in which the role of infection is limited, if any, and a contribution of genetic factors is anticipated. Previously, we performed a genome-wide association study (GWAS) on diffusetype GC by using single nucleotide polymorphisms (SNP) catalogued for Japanese population (JSNP), and identified a prostate stem cell antigen (PSCA) gene encoding a glycosylphosphatidylinositol-anchored cell surface antigen as a GC susceptibility gene. From the second candidate locus identified using the GWAS, 1q22, we found the Mucin 1 (MUC1) gene encoding a cell membranebound mucin protein as another gene related to diffuse-type GC. A two-allele analysis based on risk genotypes of the two genes revealed approximately 95% of Japanese population have at least one of the two risk genotypes, and approximately 56% of the population have both risk genotypes. The two-SNP genotype might offer ample room to further stratify a high GC risk subpopulation in Japan and Asia by adding another genetic and/or non-genetic factor. Recently, a GWAS on the Chinese population disclosed an additional three GC susceptibility loci: 3q13.31, 5p13.1 and 10q23. (Cancer Sci 2013; 104: 1-8) G astric cancer (GC) is one of the major malignant diseases and the second causal of cancer death worldwide.(1) It is usually classified into two types, intestinal and diffuse, a classification which was originally based on histological observation but is recently thought to reflect its pathogenesis.(2) The majority of intestinal-type GC (IGC) arises in the sequence of inflammatory change of the gastric epithelium resulting from bacterial infection; Helicobacter pylori (HP) infectionchronic inflammation -intestinal metaplasia -dysplasia -adenocarcinoma. In contrast, de novo diffuse-type GC (DGC) is thought to emerge in a histologically almost normal epithelium as a consequence of some genetic change that occurred in gastric stem cells and/or epithelial precursor cells, although some cases with DGC might represent dedifferentiated stages of IGC, and a contribution of HP is also suggested.(3) In other words, it is apparent that the pathogenesis of IGC is initiated by HP infection, a class I carcinogen acknowledged by WHO, and therefore IGC is essentially a preventable disease by eradicating HP infection. However, DGC might develop earlier in life than IGC, (4) and no definite DGC-specific environmental risk factor has been established. Therefore, so far we have neither solid strategy nor promising theory to envision a consistent diminution of the incidence of DGC.The incidence of GC has strong geographical and ethnical characteristics. For example, it is one of the rare cancers in North America and Europe, while its incidence is s...