People who experience facial flushing when they drink alcohol are much more likely 1 to develop alcohol-related esophageal cancer, say American and Japanese experts.

Enzyme Deficiency Linked To Cancer

Facial flushing, nausea and increased heart rate when drinking alcohol occurs in about a third of East Asians (Chinese, Japanese and Koreans), mainly due to an inherited deficiency in an enzyme called aldehyde dehydrogenase 2 (ALDH2). There is increasing evidence that people with this deficiency are at much higher risk for alcohol-related esophageal cancer (specifically squamous cell carcinoma) than people with fully active ALDH2, the experts wrote in an article in PLoS Medicine

Esophageal Cancer One Of Deadliest

However, many doctors and people with alcohol-flushing response aren't aware of this increased risk. This lack of awareness is "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," noted Phillip Brooks, PhD, and colleagues at the U.S. National Institute on Alcohol Abuse and Alcoholism, and Akira Yokoyama, MD, of the Kurihama Alcohol Center in Japan.

Be Aware Of Flushing From Alcohol

"Our goal in writing this article is to inform doctors firstly that their ALDH2-deficient patients have an increased risk for esophageal cancer if they drink moderate amounts of alcohol, and secondly, that the alcohol flushing response is a biomarker for the ALDH2 deficiency, according to the researchers.

ALDH2 deficiency can be determined by asking patients about previous episodes of alcohol-induced flushing, the experts said.

"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," Dr. Brooks and colleagues said.

Reducing Rates Of Esophageal Cancer

There are about 540 million ALDH2-deficient people worldwide, which means even a minor reduction in the rate of alcohol-related esophageal cancers would save a large number of lives.

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