Facial Flushing After Alcohol Consumption a Risk Factor for Esophageal Cancer

People who experience facial flushing after drinking alcohol should be particularly wary of esophageal cancer, researchers warn.

About one third of East Asians (Chinese, Japanese and Koreans) have an inherited deficiency in an enzyme called aldehyde dehydrogenase 2 (ALDH2) that causes their skin to flush when they drink alcohol.

Researchers from the National Institute on Alcohol Abuse and Alcoholism found that even moderate drinkers with this deficiency were more at risk of esophageal cancer, one of the deadliest forms of cancer worldwide.

This deficiency is due to problems in metabolizing alcohol, leading to an accumulation of a substance called acetaldehyde which can damage DNA and stop cells from repairing that damage.

People with two copies of the gene responsible have such unpleasant reactions that they are unable to consume large amounts of alcohol. This reluctance actually protects them against the increased risk for cancer.

But those with only one copy can develop a tolerance to acetaldehyde and become heavy drinkers.

“What we’re trying to do here is to raise awareness of this risk factor among doctors and their ALDH2-deficient patients,” said Dr. Philip J. Brooks, an investigator with the National Institute on Alcohol Abuse and Alcoholism, whose study appears in the Public Library of Science journal PLoS Medicine.

“We hope that, by raising awareness of this important public health problem, affected individuals who drink will reduce their cancer risk by limiting their alcohol consumption,” he said.

An ALDH2-deficient person who has two beers a day has 6-10 times the risk of developing esophageal cancer than a person not deficient in the enzyme.

The researchers calculate that if moderate or heavy drinker with ALDH2-deficient reduced their consumption to less than 16 drinks a week, 53 percent of esophageal squamous cell cancers in that group could be prevented.

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