Increased risk of head and neck cancer in association with GSTT1 nullizygosity for individuals with low exposure to tobacco Tobacco and alcohol are important contributing factors to the development of squamous cell carcinoma of the head and neck (SCCHN) (Blot et al., 1988;Vokes et al., 1993). However, recent case-control studies indicate that SCCHN is also associated with a family history of this cancer (Copper et al., 1995;Foulkes et al., 1995Foulkes et al., , 1996. In addition, second primary tumors, which are often a hallmark of inherited susceptibility to cancer, occur in up to 30% of patients with SCCHN (Day and Blot, 1992;Jones et al., 1995). A family history of SCCHN is more common for these cases than for single primary cases (Bongers et al., 1995;Foulkes et al., 1996) and it has been reported that non-smoking SCCHN patients are significantly more likely to be mutagen-sensitive than current smokers . It is, therefore, reasonable to suspect a role for inherited factors in determining predisposition to SCCHN. Since large pedigrees with numerous cases of SCCHN are uncommon (Foulkes et al., 1996), genetic susceptibility to SCCHN is likely to be conferred by cancer genes of low penetrance.We and others (Vineis et al., 1994;Foulkes et al., 1996) All cases and controls were genotyped for presence or absence of both the GSTT1 and GSTM1 genes. Genotyping of GSTM1 was performed on genomic DNA by PCR amplification as previously described using three primers that amplify the GSTM1 sequence and a second internal control sequence simultaneously (Zhong et al.,1993). Absence of GSTM1-specific product indicated homozygosity for the null allele. The GSTT1 genotype was determined according to the method of Pemble et al. (1994) modified to incorporate the simultaneous amplification of partial -globin sequences to serve as an internal control . As in the case of GSTM1, the absence of a GSTT1-specific product was indicative of homozygosity for the null allele.We observed 70 GSTT1 positives and 9 GSTT1 nulls in cases, compared with 81 positives and 20 nulls in controls (OR ϭ 2.57, p ϭ 0.04