Methylation of the CpG island in the MGMT promoter region is a frequent event in several cancer types including colorectal cancer, lung cancer, lymphoma, and glioblastoma. A correlation between methylation and the T allele of the rs16906252 single nucleotide polymorphism (SNP) in colorectal carcinomas has previously been reported. As aberrant MGMT methylation can be an early event in tumor development, we tested the hypothesis that normal individuals possessing the T allele may be predisposed to somatic methylation at the MGMT promoter. Peripheral blood monononuclear cell DNA from 89 normal, healthy individuals was genotyped at rs1690625 and assessed for the methylation status of the MGMT promoter region using independent quantitative methodologies capable of detecting lowlevel methylation: MethyLight and Sensitive Melting Analysis after Real-time MethylationSpecific PCR (SMART-MSP). There was a strong association between presence of the T allele and detectable methylation (P = 0.00005) in the peripheral blood DNA. Furthermore, when a MSP assay flanking the SNP was used to amplify methylated sequences in heterozygotes, only the T allele was methylated. Thus, detectable somatic methylation of the MGMT promoter in normal individuals is strongly associated with the T allele of the rs16906252 MGMT promoter SNP.Inactivation of tumor suppressor genes and DNA stability genes by promoter methylation is a common occurrence in human cancer. In some cases, epigenetic inactivation of one of these genes is likely to be the initiating event in cancer development (reviewed in ref. 1). Evidence for this is particularly strong for certain hereditary cancer genes where constitutional methylation of the gene predisposes to cancer development (2-4).It is also likely that constitutional methylation of other genes not normally involved in heritable cancer can predispose to cancer. One of the most plausible candidates for a gene whose inactivation may initiate carcinogenesis is MGMT, which codes for a protein that removes alkyl adducts from the O6 position of guanine (5). Loss of MGMT function will give rise to a mutator phenotype, as alkylation damage from a variety of environmental sources is a common occurrence and as alkylated guanine is likely to mispair with thymine during DNA replication. MGMT methylation is commonly found in various cancers including colorectal cancers, gliomas, head and neck cancers, and lymphomas (6). MGMT promoter methylation has been used as a predictive marker in cancers; it indicates those individuals who are likely to respond to chemotherapy with alkylating agents (7,8).MGMT methylation may be an early or even predisposing event in colorectal cancer. Esteller et al. (9) reported that MGMT methylation was present in adenomas. Shen et al. (10) reported that MGMT methylation was found in apparently normal colonic tissue up to 10 cm from an MGMT-methylated colorectal cancer indicating that MGMT methylation can even be observed prior to any detectable change in morphology.Ogino et al. (11) investi...