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Alcohol Flushing Response May Indicate Cancer Risk

The alcohol flushing response, seen in approximately 36% of East Asians (Japanese, Chinese, and Koreans), may be an indictor of a much increased risk of esophageal cancer from alcohol consumption in these individuals, according to a recent article in PLoS Medicine. This is particularly unfortunate as esophageal cancer is one of the deadliest cancers worldwide, with five-year survival rates of 15.6% in the United States, 12.3% in Europe, and 31.6% in Japan, the authors noted. The flushing response is predominantly due to an inherited deficiency in the enzyme alcohol dehydrogenase 2 (ALDH2), and there is accumulating evidence that individuals deficient in ALDH2 are at a much higher risk of esophageal cancer than are those with normal levels of ALDH2. The authors advised that doctors should counsel their ALDH2-deficient patients to limit alcohol consumption and thereby reduce the risk of developing esophageal cancer. Clinicians can determine ALDH2 deficiency simply by asking about previous episodes of alcohol-induced flushing. As a result, ALDH2-deficient patients can then be counseled to reduce alcohol consumption, and high-risk patients can be assessed for endoscopic cancer screening. In view of the approximately 540 million ALDH2-deficient individuals in the world, many of whom now live in Western societies, even a small percent reduction in esophageal cancers due to a reduction in alcohol drinking would translate into a substantial number of lives saved, the authors asserted. [PLoS Medicine article]