What type of cancer is associated with alcohol-induced flushing?

From the Guidelines

Alcohol flushing is associated with an increased risk of esophageal cancer, particularly squamous cell carcinoma of the esophagus, due to the accumulation of carcinogenic acetaldehyde. This condition is often referred to as "Asian flush" or "Asian glow" and occurs when an individual lacks sufficient aldehyde dehydrogenase 2 (ALDH2) enzyme activity, necessary for proper alcohol metabolism. When someone with this deficiency consumes alcohol, acetaldehyde builds up, causing symptoms such as facial flushing, nausea, rapid heartbeat, and headaches, as noted in a study on gene-alcohol interactions and glaucoma 1. The key points to consider are:

• The ALDH2 enzyme plays a central role in alcohol metabolism, converting acetaldehyde to nontoxic acetic acid.
• Polymorphisms in the ALDH2 gene, common in East Asian populations, can lead to an inactive form of the enzyme, resulting in systemic acetaldehyde accumulation when alcohol is consumed.
• Characteristic effects of ALDH2 enzyme deficiency include reduced alcohol tolerance and alcohol-induced facial flushing, tachycardia, and palpitations, as observed in a South Korean study on drinking-related facial flushing in overweight men 1. Given the carcinogenic nature of acetaldehyde and its direct impact on esophageal tissues during alcohol consumption, the best prevention for those with alcohol flushing syndrome is to limit or avoid alcohol consumption entirely, as there are no medications or treatments that can safely increase ALDH2 enzyme activity or prevent the associated cancer risk.

From the Research

Cancer Associated with Alcohol Flushing

• Alcohol flushing syndrome is associated with an increased risk of certain types of cancer, including:
  • Esophageal squamous cell carcinoma 2
  • Gastric adenocarcinoma 2
• The risk of cancer is higher in individuals who consume more than 200g of pure ethanol per week 2
• The alcohol flushing response, often caused by ALDH2 deficiency, is a significant risk factor for esophageal cancer from alcohol consumption 3
• Acetaldehyde, a byproduct of alcohol metabolism, is a Group 1 carcinogen and has been linked to an increased risk of gastric cancer 4, 5
• Genetic variations in the ALDH2 gene, common in East Asians, can lead to impaired acetaldehyde metabolism and increased cancer risk 6