If he drinks a lot, he can be up to 56 times more likely to
end up with esophageal cancer compared to a nondrinker.

Many people of East Asian descent react to alcohol with a red face, a racing heartbeat and a slight sick feeling in their stomach. This “Asian glow” is more than just annoying though. If they keep drinking anyway, it can be downright dangerous.

In addition to its obvious charms, drinking alcohol definitely has some drawbacks (besides beer goggles and nasty hangovers). One of these is an increased risk for getting cancer of the esophagus. One study I saw claimed that heavy drinkers are 18 times more likely to end up with esophageal cancer compared to teetotalers.

The risk is even higher for blushers. They are 56 times more likely to end up with this particular cancer if they are heavy drinkers. And even if they just have a couple of drinks a day, they are still at a 5 times higher risk.

Unfortunately, the alcohol flushing response is pretty common. Scientists estimate that 36% of people of East Asian descent respond to alcohol this way. That’s over 500 million people worldwide.

All of these statistics are especially scary because esophageal cancer is so common. For example, it is the 7th leading cause of cancer death worldwide and the 7th most common cancer in men in the U.S. In some parts of Russia and China, the rates of this cancer range from 30-800 cases per 100,000 people. The rate in the U.S is 3-6 per 100,000.

Many if not most of these cancers happen because the patients drank too much alcohol and smoked too many cigarettes. One review article estimated that if heavy drinking blushers from Japan switched to just two drinks per day, the number of cases of esophageal cancer there would be cut in half. Undoubtedly the same thing is true elsewhere.

Everyone is at a higher risk for esophageal cancer when they drink because of how alcohol is broken down in the body. On the way to converting alcohol to the safer acetic acid, our bodies first turn it into acetaldehyde. And that is some nasty stuff!

Acetaldehyde likes to stick to and damage our DNA. Not only that, it also keeps our cells from repairing the damage. Since cancer happens because of DNA damage, it isn’t surprising that alcohol causes an increased risk for cancer.

People who blush from alcohol have a certain version of the ALDH2 gene that has trouble converting alcohol into acetaldehyde. The end result is a build up of acetaldehyde that can damage DNA and so cause esophageal cancer.

Again, there is no increased risk if they don’t drink. In the absence of alcohol, they are just like anyone else. They just need to lay off the liquor.

Maybe these people need to find a new social lubricant. I guess it’s too bad Prop 19 didn’t pass…

A fun activity to learn more about the genetics and biology of the alcohol flushing response.

A review article that raises an alarm about the risks of drinking alcohol as a blusher.

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A Dangerous Blush 6 July,2011Dr. Barry Starr
  • GH

    I am of East Asian descent, and I did have this blushing problem for the less-than-handful times I drank. I have long decided since then, that I am LITERALLY allergic to alcohol, because of how quickly my body reacts to it. Thank goodness for not drinking!

  • Barry Starr

    You might have two copies of the broken ALDH2 gene. These folks are so sensitive that they are actually at a lower risk than people with just one copy because drinking alcohol makes them so ill.

  • GH

    Thanks for letting me know!!! I would have thought that I am at a higher risk because of two copies, had it not been your explanation!

    Is there way to get tested for this at all, just out of curiosity?

  • Barry Starr

    When people don’t drink, they are not at a higher risk. This is why people with two copies aren’t at a higher risk…the effect of the alcohol is so bad they just don’t drink. If they were to regularly drink they would be at a higher risk. I know 23andMe tests for this trait.

Author

Dr. Barry Starr

Dr. Barry Starr (@geneticsboy) is a Geneticist-in-Residence at The Tech Museum of Innovation in San Jose, CA and runs their Stanford at The Tech program. The program is part of an ongoing collaboration between the Stanford Department of Genetics and The Tech Museum of Innovation. Together these two partners created the Genetics: Technology with a Twist exhibition.

You can also see additional posts by Barry at KQED Science, and read his previous contributions to QUEST, a project dedicated to exploring the Science of Sustainability.

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