Carcinogenic aromatic amines such as 4-aminobiphenyl, which is contained in tobacco smoke, are one of the causal factors of urothelial epithelial cancers. 4-Aminobiphenyl has been shown to be bioactivated through N-hydroxylation by hepatic cytochrome (CYP) 1A2 and subsequently through O-sulfation and O-acetylation by phenol sulfating sulfotransferase, ST1A3 (SULT1A1), and arylamine N-acetyltransferase, NAT2, respectively. In a case-control study for urothelial epithelial cancers, low activity alleles of NAT2 are overall high-risk alleles (OR 2.11; 95% CI 1. Urothelial transitional cell carcinoma (bladder, ureter and renal pelvis) is one of the most serious health problems occurring in Japan. 1 Carcinogenic aromatic amines, such as 4-aminobiphenyl detected in cigarette smoke, are hypothesized to be a major causal factor for the etiology of urothelial cancers. 2 Carcinogenic aromatic amines are known to undergo N-hydroxylation by hepatic cytochrome P450s (CYPs). 3,4 Subsequently, the produced N-hydroxy aromatic amines are further O-acetylated and O-sulfated by arylamine N-acetyltransferase (NAT) and phenol (aryl) sulfotransferase (SULT), respectively, to yield highly reactive intermediates capable of binding to DNA. 3,5 NAT is composed of NAT1 and NAT2; the former is expressed in many human tissues including the uroepithelium and the latter is mainly expressed in the liver. 6 Both NAT1 and NAT2 have been shown to catalyze the O-acetylation of a number of carcinogenic N-hydroxy aromatic amines. 7 Epidemiologic studies have shown that slow acetylator phenotype is associated with an increased risk of urothelial cancer, especially among occupationally exposed dye workers. 8,9 Genetic polymorphisms of NAT1 and NAT2 have been reported in Asians as well as Caucasians, and are well correlated with NAT activities. 10,11 In our previous study, those who are homozygous for low NAT2 activity alleles are predisposed for urothelial cancer in a Japanese population. 12 Furthermore, individuals with combined NAT1*10 and NAT2 low activity allele(s) showed increased risk for urothelial cancer. 12 A form of phenol SULT, ST1A3 (SULT1A1), has been shown to efficiently catalyze the metabolic activation of an N-hydroxy derivative of 4-aminobiphenyl. 13,14 Different alleles of ST1A3 (SULT1A1) were reported as *2 (213Arg3His), *3 (223Met3Val) and *4 (37Arg3Gln). 15,16 We investigated allele frequency of the variant ST1A3 alleles in a Japanese population and calculated allele frequency of *1 and *2 as 0.83 and 0.17, respectively. Frequency of *3 was a rare allele (frequency less than 0.01). 17 ST1A3*2 has been shown to be unstable and to lose its enzymatic activity substantially faster than the wild-type ST1A3*1 did. 17,18 Role of the genetic polymorphism in ST1A3 (SULT1A1) in urothelial cancer susceptibility has never been evaluated, although the frequency of the *2 allele was relatively high in a Japanese population as well as Caucasians. 15,16 In our study, we evaluated effects of the different and relatively frequent allele of ST1A3 (SU...