Likely sporadic cancers caused by MLH1 promoter hypermethylation were associated with an older age at first cancer diagnosis compared with individuals with Lynch syndrome (median 71.5 vs 52 years, P = 5.3 × 10−4, Wilcoxon rank sum test) and a lower proportion of patients had Prediction Model for Gene Mutations (PREMM5) scores ≥2.5% (32% vs 78%, P = 2.7 × 10−3, Fisher exact test). The gene discussed is MLH1; the disease is Lynch syndrome.