ALDH2 deficiency is relatively common, occurring in about 36% of Eastern Asian individuals. Alcohol consumed by ALDH2-deficient individuals is metabolized to acetaldehyde, which accumulates in the body owing to absent ALDH2 activity and results in facial flushing, nausea, and tachycardia. Accumulating evidence shows that ALDH2-deficient individuals are at much higher risk for esophageal cancer (specifically squamous cell carcinoma) from alcohol consumption than individuals with fully active ALDH2, even at relatively moderate intakes of alcohol. It is believed that ALDH2-deficient individuals experience higher levels of acetaldehyde-related DNA and chromosomal damage when they consume alcohol, providing a likely mechanism for the increased cancer risk.
Informing patients with ALDH2 deficiency, especially young people who are drinking alcohol for the first time, of their increased risk for esophageal cancer from drinking poses a valuable opportunity for cancer prevention. Of note, ALDH2 deficiency does not influence esophageal cancer risk in nondrinkers. ALDH2 deficiency has been associated with increased breast cancer risk, although the data do not provide a clear consensus regarding alcohol-associated breast cancer cases in that population. Whether alcohol-associated liver cancer is influenced by ALDH2 deficiency is unclear.
Learn more about esophageal cancer.
This Fast Five Quiz was excerpted and adapted from the Medscape article Quiz: The Alcohol-Cancer Connection.
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Cite this: Elwyn C. Cabebe. Fast Five Quiz: Alcohol and Cancer - Medscape - Feb 23, 2022.