March 24, 2009 -- A red face after drinking alcohol may be a warning sign of esophageal cancer risk.
A new report shows people who experience a red face or flushing after drinking alcohol have a much higher risk of developing esophageal cancer than those who do not.
Researchers say about a third of Japanese, Chinese, and Koreans have this red-face response to drinking alcohol along with nausea and increased heart rate. The reaction is primarily due to an inherited lack of an enzyme called aldehyde dehydrogenase 2 (ALDH2).
Researchers say few doctors and health care providers are aware of the accumulating evidence that ALDH2-deficient individuals are at much higher risk of esophageal cancer (specifically squamous cell carcinoma) from alcohol consumption than individuals with fully active ALDH2.
"This is particularly 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," write researcher Philip J. Brooks, MD, of the National Institute on Alcohol Abuse and Alcoholism, and colleagues in PLoS Medicine.
Researchers say studies in Japan and Taiwan show that people who consistently experience a red face after drinking alcohol have an increased risk of developing alcohol-related esophageal cancer, even if they are only moderate drinkers. Some studies suggest the risk may be up to 18 times greater, with heavy drinkers facing the biggest risk.
However, researchers say it is important to point out that this increased risk of esophageal cancer among ALDH2-deficient people is only for those who drink alcohol. Nondrinkers do not appear to have a higher risk of esophageal cancer.
Brooks and colleagues say health care providers should ask their patients about whether they experience redness after drinking alcohol. If so, this should be treated as a warning sign of heightened esophageal cancer risk, requiring screening.
Those who experience a red face after drinking alcohol should also be advised to reduce alcohol use to reduce their future risk of esophageal cancer.