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Red-faced Asian drinkers at esophageal 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, US and Japanese researchers said yesterday.

They said 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 of 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 estimates 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 drinking alcohol.

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

"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."

Brooks said doctors should ask patients of East Asian descent of they have a history of facial flushing when they drink.

And he said university health professionals need to be aware of the link between facial flushing and cancer risk since many young people experiment with heavy drinking in college.


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