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'Asian flush' indicates enlarged cancer risk

ASIANS who get red in the face when they drink too much alcohol have a higher risk of getting cancer of the esophagus, United States and Japanese researchers said yesterday.

They reported that about a third of East Asians - Chinese, Japanese and Koreans - have an enzyme deficiency that causes their skin to flush when they drink alcohol, and this trait puts them at higher risk for developing esophageal cancer, an especially deadly type with five-year survival rates of 12 to 31 percent.

"People are fairly well aware of this physical characteristic, which is sometimes called the Asian alcohol response or the Asian flush," said Philip Brooks of the National Institute on Alcohol Abuse and Alcoholism, whose study appears in the Public Library of Science journal PLoS Medicine.

"I don't think people are aware that it is a warning sign for being at risk of esophageal cancer when they drink alcohol. That is what we wanted to point out," said Brooks, who worked on the study with Dr Akira Yokoyama from the Kurihama Alcohol Center in Japan.

Brooks estimated that at least 540 million people have this alcohol-related increased risk for esophageal cancer.

He said the flushing response occurs in people who have a variation in the ALDH gene, which makes an enzyme called aldehyde dehydrogenase 2 that helps the body metabolize alcohol.

People with two copies of this gene variant have such extreme symptoms of flushing, nausea and racing heart beat that they avoid alcohol.

Brooks said: "They are basically at somewhat reduced risk of developing esophageal cancer because drinking alcohol for anybody is a risk factor for esophageal cancer.

"The concern is for people who have one copy," he said, "because they can tolerate drinking. In general, people with one copy have about a six to tenfold increase in the incidence of esophageal cancer."


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