CDH1 and gastric cancer: Signet-ringcell carcinoma (comparable to poorly differentiated GC) is steadily increasing inincidence within the United States and around the world.9 This increase is attributed to (1) eradication efforts of Helicobacterpylori, a pathogen known to induce intestinal type GC, (2)increases in genetic predisposition to genes such as E-cadherin(CDH1) hypermethylation, and (3) less screening and detectiondue to the “low risk” population within the United States compared to other regionssuch as Japan.10