Abstract.A polymorphism within the 3'-UTR 8473T¨C of the cyclooxygenase-2 (COX-2) gene, which plays a role in gastrointestinal cancer development, has been associated with susceptibility to malignant disease. Here, we report on the interaction between the COX-2 3'-UTR T¨C polymorphism and gastric cancer development. DNA from 121 Japanese patients with gastric cancer and 126 age-matched control patients was examined for the COX-2 polymorphism by PCR-RFLP. Odds ratios and the 95% confidence interval (CI) were calculated. Homozygous carriage of the COX-2 8473C allele tended to be associated with an increased risk of gastric cancer compared to the T allele homozygotes of the subjects (OR=3.70; 95% CI, 0.96-14.25). The CC allele was associated with a significant increased risk of diffuse-type gastric cancer (OR=5.29; 95% CI, 1.18-23.70). These findings suggest that the COX-2 3'-UTR 8473T¨C polymorphism could be used as a marker for genetic susceptibility to gastric cancer in Japanese populations.