Validation study of a health risk appraisal model and endoscopic screening for early esophageal cancer in men in specialized hospitals

Background

This study was designed to validate a health-risk appraisal (HRA) model for identifying Japanese men in specialized hospitals who were at high risk for esophageal cancer on the basis of their past and present facial flushing reactions after drinking alcohol, drinking and smoking status, and intake of vegetables and fruit.

Methods

We prospectively studied men 50 years or older with no history of head and neck cancer or esophageal cancer who presented at Kitasato University Hospital to undergo endoscopic examination from January 2011 to March 2013. The subjects responded to an HRA questionnaire before examination.

Results

Among the 164 patients enrolled, 157 were eligible for analysis. The median HRA score was 3 in patients aged 70–90 years and 6 in those aged 50 to 69 years. Early esophageal cancer was diagnosed on endoscopic examination in 3 subjects (1.9%, 3/157). Among 70 patients 70–90 years of age, 18 (25.7%, 18/70) had an HRA score of 7 or higher, and early esophageal cancer was detected in 2 (11.1%, 2/18) of these patients. Early esophageal cancer was not detected in 87 patients 50–69 years of age. Early esophageal cancer was detected in a 70-year-old patient with an HRA score of 2 who had no history of drinking alcohol or smoking.

Conclusions

Our results suggest that an HRA questionnaire is useful for identifying persons 70 years or older who are at high risk for alcohol-related esophageal cancer in specialized hospitals.

     

The effect of a practice‐based multicomponent intervention that includes health coaching on medication adherence and blood pressure control in rural primary care

Low adherence to anti‐hypertensive medications contributes to worse outcomes. The authors conducted a secondary data analysis to examine the effects of a health‐coaching intervention on medication adherence and blood pressure (BP), and to explore whether changes in medication adherence over time were associated with changes in BP longitudinally in 477 patients with hypertension. Data regarding medication adherence and BP were collected at baseline, 6, 12, 18, and 24 months. The intervention resulted in increases in medication adherence (5.75→5.94, P = .04) and decreases in diastolic BP (81.6→76.1 mm Hg, P < .001) over time. The changes in medication adherence were associated with reductions in diastolic BP longitudinally (P = .047). Patients with low medication adherence at baseline had significantly greater improvement in medication adherence and BP over time than those with high medication adherence. The intervention demonstrated improvements in medication adherence and diastolic BP and offers promise as a clinically applicable intervention in rural primary care.     

A health‐risk appraisal model and endoscopic mass screening for esophageal cancer in Japanese men

A strong association between inactive aldehyde dehydrogenase‐2 (ALDH2) and risk of esophageal cancer has been demonstrated in East Asian drinkers. An alcohol flushing questionnaire asking about past and current tendency for facial flushing to occur after drinking a glass (≈180 mL) of beer predicts the presence of inactive ALDH2 among Japanese aged 40 years or older with a sensitivity and specificity of approximately 90%. We invented a health‐risk appraisal (HRA) model that makes it possible to identify Japanese men who are at high risk for esophageal cancer based on their past and current alcohol flushing tendency, drinking, smoking, and intake of vegetables and fruits. Between 2008 and 2009, 2221 Japanese men aged 50 years or older filled out the HRA questionnaire before undergoing a screening examination by upper gastrointestinal endoscopy at five medical facilities. The endoscopic examination resulted in a diagnosis of esophageal cancer in 19 subjects, and 117 (5.27%) subjects had an HRA score ≥11. The proportion of subjects with an HRA score ≥11 was higher in the 50–69 age group (6.11–6.88%) than in 70–89 age group (2.84–2.86%). The esophageal cancer detection rate was 4.27% among the subjects with an HRA score ≥11 and only 0.67% among the other subjects. Based on a receiver operating characteristic curve analysis, when an HRA score of ≥9 was used for subjects aged 50–69 years and of ≥8 for those aged 70–89 years as the cutoff value to select individuals with a high risk for esophageal cancer, its sensitivity and false‐positive rate was 52.6% and 15.2%, respectively, and the cancer detection rate was 2.91% in the high‐risk group, as opposed to 0.48% in the other group. In conclusion, the high detection rates for esophageal cancer in the high‐risk groups encouraged screening based on our HRA model in larger Japanese populations.     

Feasibility and yield of a self-administered questionnaire for health risk appraisal in older people in three European countries

OBJECTIVE: To test the feasibility of a self-administered questionnaire for health risk appraisal in older people. METHODS: A scientifically updated and culturally adapted English and German language version of the Health Risk Appraisal for Older Persons self-administered questionnaire identifying risk factors for functional impairment in older people was administered to three samples of older people (UK: Urban-based general practitioner list, n=348; Switzerland: Community-based lists in rural/suburban area, n=213; Germany: Occupants of residential care facilities, n=149). RESULTS: The majority of people judged the questionnaire as easy to comprehend (UK 81.4%; Switzerland 97.2%; Germany 93.1%) and to complete (83.2%, 95.8%, 91.4%). Prevalence of risk factors was higher than 10% at each site for excessive fat intake (25-54%), lack of social activity (15-47%), low physical activity (28-46%), impaired vision (17-38%), impaired hearing (23-25%), and urinary incontinence (13-37%). Uptake of recommended preventive health measures, including screening and vaccination was below 50% in more than half of recommended items, with large variations between sites. DISCUSSION: Acceptance of the adapted Health Risk Appraisal for Older Persons questionnaire was high and its feasibility supported. The findings identified a high prevalence of potentially modifiable risk factors for ill health and disability in older people with large variations in prevalence rates and awareness between sites. The yield supports the further development and evaluation of the approach.     

Difference in subjective well-being between ethnic Korean and Japanese elderly residents in an urban community in Japan

Background:   The ethnic Korean community in Japan has witnessed the increasing aging of their population structure. The purpose of our study was to clarify the differences in standards of living between elderly ethnic Korean and elderly Japanese populations living in Japan, and to examine whether there is any difference in subjective well-being between the two populations.
Methods:   We conducted a cross-sectional questionnaire-based survey that consisted of items addressing ethnicity, age, gender, literacy, living conditions, mental health, "sense of purpose in life", activities of daily living (ADL), medical history, quality of life (QOL), and receipt of pension benefits and public assistance; the participants were 425 elderly people (ethnic Korean residents in Japan, n  = 204; Japanese, n  = 221) aged 65 and older living in a community in Osaka City. Findings from the two groups were compared using the Student's t -test and the χ² test. We also employed multiple linear regression analysis.
Results:   We found that the ethnic Korean group had less formal education ( P  < 0.001), lower ADL ( P  < 0.05) and QOL ( P  < 0.001), higher illiteracy ( P  < 0.05) and depression rates ( P  < 0.001), and a higher prevalence of hypertension, myocardial infarction and diabetes mellitus than the Japanese group. Ethnicity was a significant variable for subjective well-being in simple linear regression analysis. After adjusting for literacy, absence of sense of purpose in life and mental health in multiple regression analysis, ethnicity remained a significant variable.
Conclusions:   The present findings indicate that ethnic Korean elderly have poor health and social situations compared with the Japanese group, and that there was a difference in subjective well-being between the two ethnic groups.     

中国老年人宗教信仰的城乡差异及原因

目的分析城乡老年人的宗教信仰状况。方法使用2010年第三次中国妇女社会地位调查的全国性数据,对老年人宗教信仰的城乡分布、地区分布基本状况进行实证分析。结果老年人宗教信仰存在显著的城乡和地区差异,这主要是城乡老年教徒在经济收入、健康状况、社会养老保障和受教育程度上存在显著差异,以及城乡人口老龄化倒置所导致。老年人信仰宗教形成的信仰共同体提供的社会保障是老年人信仰宗教的重要原因,农村社会保障体系不完善、社会保障水平低是老年人宗教信仰城乡差异的根本原因。结论加快完善农村社会养老保障制度、构建农村老年人社会养老服务体系的任务迫在眉睫。     

Long-term survivors of advanced esophageal cancer without surgical treatment: a multicenter questionnaire survey in Kyushu, Japan

Since the introduction of recent improvements in adjuvant therapy for esophageal cancer, some patients have demonstrated good prognosis. In the present study, we analyzed 3- and 5-year survivors of advanced esophageal cancer who did not undergo any surgical treatment. Between 1990 and 1998, 831 patients were admitted to 14 university hospitals and one cancer center associated with the membership of the Kyushu study group for adjuvant therapy of esophageal cancer. Twelve (1.4%) of the patients were 3-year survivors and 13 (1.6%) were 5-year survivors. The reasons for non-operation were refusal (eight patients), tumor-related factors (11 patients), and host-related factors (six patients). With a single exception, all patients had locally advanced tumors. Almost all long-term survivors had fewer than five lymph node metastases, in regions limited to the neck and/or mediastinum. Radiation therapy was combined with chemotherapy for 16 of the 25 patients, and chemotherapy-based cisplatin was used for 15 of these 16 patients. Fifteen of the patients remain alive; 10 died seven of them from esophageal cancer. Chemoradiation therapy was effective for some patients with locally advanced esophageal cancer, particularly in the absence of or with few lymph node metastases. To improve the prognosis of patients with advanced esophageal cancer who, for various causes, cannot undergo surgical treatment, a new protocol for adjuvant therapy is required.     

Rheumatoid arthritis in Senegal: a comparison between patients coming from rural and urban areas, in an urban tertiary health care center in Senegal

Several studies have suggested that rheumatoid arthritis (RA) is uncommon in rural sub-Saharan Africa. The aim of this study is to determine the potential differences between patients with RA living in rural areas and those living in urban areas. We performed a cross-sectional study from June 2006 to May 2009. We included all patients with RA (1987 ACR criteria) seen at the Rheumatology Unit of the Le Dantec Teaching Hospital, Dakar, Senegal. We compared the main socio-demographic and clinical characteristics of patients living in rural areas to those living in urban areas. We included 180 patients in our study, of whom, 143 (79.4?%) lived in urban areas and 37 (20.6?%) in rural areas. The median age was 44?years [range 34–55] in patients from rural areas vs. 41?years [range 30–53] in patients from urban areas, without any statistical significance (p?=?0.24). Patients under the age of 60 mostly lived in urban areas (p?=?0.03). The extra-articular manifestations were significantly more frequent in patients living in rural areas (p?=?0.02). There was no statistical significance when comparing the delay in diagnosis, number of swollen joints, disease activity, hand deformities, and concentration of autoantibodies (RF and ACPA) in both populations. The percentage of patients seen from the rural areas of Senegal is low (20.6?%) compared to those seen from the urban areas. The number of extra-articular manifestations is the main difference between patients living in rural and urban areas. The role played by environmental factors seems important. Further incidence studies are needed.     

Clinical features and treatment of patients with esophageal cancer and a history of gastrectomy: a multicenter,questionnaire survey in Kyushu,Japan

It is still controversial whether patients with a history of gastrectomy have high risk of esophageal carcinogenesis. On the other hand, the treatment strategy for esophageal cancer patients after gastrectomy is complicated. The association between histories of gastrectomy and esophageal carcinogenesis was retrospectively analyzed, and the treatment of esophageal cancer patients after gastrectomy was evaluated based on questionnaire data collected from multiple centers in Kyushu, Japan. The initial subject population comprised 205 esophageal cancer patients after gastrectomy. Among them, 108 patients underwent curative surgical treatment, and 70 patients underwent chemoradiation therapy (CRT). The time between gastrectomy and esophageal cancer development was longer in peptic ulcer patients (28.3 years) than in gastric cancer patients (9.6 years). There were no differences in the location of esophageal cancer according to the gastrectomy reconstruction method. There were no significant differences in the clinical background characteristics between patients with and without a history of gastrectomy. Among the 108 patients in the surgery group, the 5‐year overall survival rates for stages I (n = 30), II (n = 18), and III (n = 60) were 68.2%, 62.9%, and 32.1%, respectively. In the CRT group, the 5‐year overall survival rate of stage I (n = 29) was 82.6%, but there were no 5‐year survivors in other stages. The 5‐year overall survival rate of patients with CR (n = 33) or salvage surgery (n = 10) was 61.2% or 36%, respectively. For the treatment of gastrectomized esophageal cancer patients, surgery or CRT is recommended for stage I, and surgery with or without adjuvant therapy is the main central treatment in advanced stages, with surgery for stage II, neoadjuvant therapy + surgery for stage III, and CRT + salvage surgery for any stage, if the patient's condition permits.     

胰腺癌相关危险因素研究及高危评分模型的建立

目的 探索胰腺癌相关危险因素，建立胰腺癌高危评分模型。方法 采用病例对照研究，收集2002年1月至2004年4月胰腺癌患者119例，正常对照238名。对所有研究对象进行流行病学问卷调查，通过两组比较确定胰腺癌相关危险因素。选择相关危险因素和症状进行多元Logistic回归分析，计算各变量的权重分数，建立高危评分模型。结果 高剂量吸烟（〉17包年）人群发生胰腺癌的风险增加（OR 1．98；95％CI 1．11～3．49），尤其是男性高剂量吸烟者（OR 2．11；95％CI 1．18～3．78）；饮酒对胰腺癌的危险性主要表现在高剂量饮洒中（OR 3．681；95％CI 1．604～8．443）。胰腺癌患者中以肉食为主者占31．03％，而对照组中仅为7．61％（P〈0．0001）；有糖尿病史的胰腺癌患者占18．49％，而对照组仅为5．77％（P=0．0003），胰腺癌组中患糖尿病时间中位数为0．5年，对照组为4年；临床症状中厌食、上腹痛、腹胀、黄疽及体重下降两组间差异有统计学意义。根据高危评分模型对两组进行评分，胰腺癌组和对照组平均分分别为80．6（95％CI，74．9～86．3）和7．4（95％CI 6．0～8．7），P〈0．001。初步确定≥45分为胰腺癌高危人群筛查界值。结论 高剂量吸烟、高剂量饮酒、肉食、糖尿病史为汉族人群的胰腺癌相关危险因素。该评分模型町用于胰腺癌高危人群的初筛．可能有助于发现早期胰腺癌患者，但还需进一步验证。     

Difference in prevalence of diabetes, obesity, metabolic syndrome and associated cardiovascular risk factors in a rural area of Tamil Nadu and an urban area of Delhi

This study compared difference in diabetes, obesity, metabolic syndrome (MetS), C-reactive protein (hs-CRP), homocysteine, and other cardiovascular risk factors between rural and urban Asian Indians using similar/standardized field measurements. The design used a cross-sectional and population-based study among rural (Tamil Nadu) and urban (Delhi) Asian Indians aged 18 years and older. 574 rural Indians and 508 urban Indians completed face-to-face interviews, and anthropometric measurements. Fasting venous blood samples were obtained for fasting plasma glucose and serum lipid tests. The mean age was 42.6?±?11.8 y (urban) and 39.5?±?13.9 y (rural). Although the prevalence of type 2 diabetes (T2DM) was lower in rural (8.4%) than urban (13.6%) areas, rural Asian Indians had a higher percent of undiagnosed cases (25%), poorer glycemic control, and unawareness of diabetes than their urban peers. Urban Indians had elevated rates of the MetS (as defined by NCEP and IDF criteria), hs-CRP, total cholesterol, LDL, and hypertension than their rural peers. Females in general had significantly higher central obesity and lower HDL-C than males. Homocysteine levels (measured only among urban respondents) was higher among males than females (p?=?.04). Prevalence of hypertension increased with age (r?=?.37, p?<?.001) and correlated with respondents’ blood glucose levels (r?=?.11, p?<?.001). There was a step-wise worsening of risk factors as individuals progressed from normal to IFG to T2DM. High burden of diabetes and other cardiovascular risk factors in urban and rural Asian Indians provide basis for tailored and cost-effective prevention and intervention programs, in such resource-constrained settings.     

Overexpression of P53 and its risk factors in esophageal cancer in urban areas of Xi'an

AIM:To investigate the risk factors of esophageal cancer (EC) in urban areas of Xi'an and to determine the association between overexpression of P53 and these risk factors.METHODS: All cases (89) and controls (97) were permanent residents in urban areas of Xi'an, all cases of primary EC had been histologically confirmed, controls were inpatients with non-cancer and nonsmoking-related disease. Cancer tissues and tissues adjacent to the cancer of 65 cases and 24 available normal esophageal tissues of controls were detected for P53 overexpression by the immunohistochemical method.RESULTS: The smoking and familial history of cancer were significantly associated with EC in Xi'an inhabitants. The laboratory assay indicated that P53 positive stain in EC was 50.0%(34/65)and 6.1%(4/65) in tissues adjacent to the cancer, but no positive stain was found in normal esophageal tissues of controls. The results showed that P53 overexpression in EC was closely related to smoking and cases with familial history of cancer.CONCLUSION: Smoking and familial cancer history were important risk factors for EC,and the alteration of P53 gene may be due to smoking and inheritance factors.     

Cardiovascular risk and social classes: a comparison between adult female populations in rural and urban areas]

The distribution of cardiovascular risk factors and the prevalence of several risk conditions are analysed in two female cohorts in southern-central Italy, one living in an urban area (the city of Naples) and the other in a rural area (the province of Latina). Analysis of different social classes identified through the level of education was also performed. The distribution of risk factors is different in the two areas (body mass index, systolic and diastolic blood pressure are higher in the province of Latina, while serum total and HDL cholesterol are higher in Naples) as well as the prevalence of several risk conditions (the prevalence of hypertension is higher in the province of Latina, whereas hypercholesterolemia and smoking are more prevalent in Naples). Cardiovascular risk factors are unevenly distributed in the different social classes: body mass index and systolic and diastolic blood pressure decrease as the educational level increases in both cohorts; in the city of Naples, serum total and HDL cholesterol increase with the increase in educational level. An awareness of these differences is crucial to targeting primary prevention campaigns in specific social classes.     

Relationship between alcohol consumption and the risks of liver cancer,esophageal cancer,and gastric cancer in China: Meta-analysis based on case–control studies

Objective: To study the correlation between alcohol consumption and the risks of liver, esophageal squamous cell carcinoma (ESCC), and gastric cancers in China mainland by meta-analysis.Methods: We systematically searched electronic databases to identify the case–control studies that reported the association between alcohol consumption and the risks of liver, ESCC, and gastric cancers from January 1, 2010 to April 1, 2020. The Newcastle–Ottawa Scale (NOS) was used to evaluate literature quality, and I² analyzes were used to evaluate the heterogeneity.Results: A total of 2855-related studies were retrieved. After conditional screening, we included 26 case–control studies for meta-analysis. Meta-analysis showed that alcohol consumption was associated with increased risks of liver, ESCC, and gastric cancers (total pooled odds ratio [OR], 1.83; 95% confidence interval [CI], 1.58–2.11; liver cancer OR, 1.83; 95% CI, 1.39–2.40; ESCC OR, 2.00; 95% CI, 1.66–2.40; gastric-cancer OR, 1.54; 95% CI, 1.10–2.15). Subgroup analysis results showed that the pooled ORs of volume of alcohol consumed, years of drinking, age of starting drinking, and drinking status were 1.71 (95% CI, 1.36–2.15), 1.65 (95% CI, 1.33–2.06), 1.38 (95% CI, 0.98–1.94), and 2.00 (95% CI, 1.42-2.81), respectively. Regression analysis showed that geographical region was a source of heterogeneity.Conclusion: Alcohol consumption increased the risks of liver cancer, ESCC, and gastric cancers in China. Volume of alcohol consumed, years of drinking, age of starting drinking, and drinking status were all significant factors for these risks.     

Polymorphisms of alcohol dehydrogenase-2 and aldehyde dehydrogenase-2 and esophageal cancer risk in Southeast Chinese males

AIM： To evaluate the impact of alcohol dehydrogenase-2 （ADH2） and aldehyde dehydrogenase-2 （ALDH2） polymorphisms on esophageal cancer susceptibility in Southeast Chinese males.METHODS： Two hundred and twenty-one esophageal cancer patients and 292 healthy controls from Taixing city in Jiangsu Province were enrolled in this study. ADH2 and ALDH2 genotypes were examined by polymerase chain reaction and denaturing high-performance liquid chromatography. Unconditional logistic regression was used to calculate the odds ratios （OR） and 95% confidence interval （CI）.RESULTS： The ADH G allele carriers were more susceptible to esophageal cancer, but no association was found between ADH2 genotypes and risk of esophageal cancer when disregarding alcohol drinking status. Regardless of ADH2 genotype, ALDH2G/A or A/A carriers had significantly increased risk of developing esophageal cancer, with homozygous individuals showing higher esophageal cancer risk than those who were heterozygous. A significant interaction between ALDH2 and drinking was detected regarding esophageal cancer risk; the OR was 3.05 （95% CI： 2.49-6.25）. Compared with non-drinkers carrying both ALDH2 G/G and ADH2 A/A, drinkers carrying both ALDH2 A allele and ADH2 G allele showed a significantly higher risk of developing esophageal cancer （OR = 8.36, 95% CI： 2.98-23.46）.CONCLUSION： Both ADH2 G allele and ALDH2 A allele significantly increase the risk of esophageal cancer development in Southeast Chinese males. ALDH2 A allele significantly increases the risk of esophageal cancer development especially in alcohol drinkers. Alcohol drinkers carrying both ADH2 G allele and ALDH2 A allele have a higher risk of developing esophageal cancer.     

Highly salted food and mountain herbs elevate the risk for stomach cancer death in a rural area of Japan

BACKGROUND: Although many case-control and experimental studies have shown that highly salted foods are risk factors for stomach cancer, only a few cohort studies have supported the relationship. METHODS: In a cohort study conducted in a rural area of Japan, 8035 residents aged over 30 years (approx. 55% were female) filled out a questionnaire. Seventy-six of them died from stomach cancer during an 11-year follow-up period. In the questionnaire, intake frequencies of 29 food items, smoking and drinking habits were investigated. Tsukemono (pickled vegetables) and tsukudani (foods deep boiled in soy sauce) are highly salted foods in the area. Frequency of each food item intake was classified into three levels, and age- and sex-adjusted risks were calculated using proportional hazard models. RESULTS: In the final model obtained by backward elimination, frequent intake of tsukemono and tsukudani and that of mountain herbs remained as significant risk factors. Compared with the least frequent intake, risk (95% confidence interval) of the most frequent intake was 5.4 (1.8-16.3) for highly salted foods (P for trend < 0.01) and 3.7 (1.4-9.6) for mountain herbs (P for trend = 0.04). CONCLUSION: Highly salted foods and mountain herbs were important risk factors for death from stomach cancer.     

Decreased risk of esophageal cancer owing to cigarette and alcohol cessation in smokers and drinkers: a systematic review and meta-analysis

Smoking cigarettes and drinking alcoholic beverages are considered very important risk factors for adverse health effects, such as many types of cancer and cardiovascular disease. In this study, we evaluated the influence of smoking and drinking cessation on risk of esophageal cancer, by means of meta-analysis. We extracted 205 studies by conducting a systematic literature search. Thirty-five studies that estimated risk reduction following smoking cessation and 18 studies conducted following drinking cessation were identified in the literature review. Former smokers had a significantly lower summary risk ratio (RR) than current smokers [RR 0.74, 95% confidence interval (CI) 0.68–0.80]. In subgroup analysis of Japanese smokers, squamous cell carcinoma, and adenocarcinoma, RRs for former smokers versus current smokers were 0.65 (95% CI 0.51–0.83), 0.60 (95% CI 0.50–0.72), and 0.93 (95% CI 0.84–1.03), respectively. The summary RR between former alcohol drinkers and current drinkers was not significant (RR 1.09, 95% CI 0.94–1.26). In our analysis of time since drinking cessation, drinkers who had stopped consuming alcohol for 5 years or more had a significantly lower summary RR than current drinkers (RR 0.78, 95% CI 0.66–0.93). Summary RR for drinkers who stopped for 10 years or more versus current drinkers was 0.65 (95% CI 0.57–0.74). Our investigation found that smoking cessation lowers esophageal cancer incidence. We also found that esophageal cancer incidence risk could be decreased in current drinkers by cessation of alcohol consumption for 5 years or more.     

Relationship between genetic polymorphisms of alcohol and aldehyde dehydrogenases and esophageal squamous cell carcinoma risk in males

AIM: To investigate the association between the genetic polymorphisms of ADH2 and ALDH2, lifetime alcohol consumption and esophageal cancer risk in the Taiwanese men. METHODS: Between August 2000 and June 2003, 134 pathologically-proven esophageal squamous cell carcinoma male patients and 237 male controls were recruited from Kaohsiung Medical University Hospital and Kaohsiung Veterans General Hospital in southern Taiwan. ADH2 and ALDH2 polymorphisms were genotyped using PCR-RFLP. RESULTS: Compared to those with ADH2*2/*2, individuals with ADH2*l/*2 and ADH2*1/*1 had 2.28-and 7.14-fold, respectively, increased risk of developing esophageal cancer (95%CI = 1.11-4.68 and 2.76-18.46) after adjusting for alcohol consumption and other covariates. The significant increased risk was also noted among subjects with ALDH2*l/*2 (adjusted OR (AOR) = 5.25, 95%CI = 2.47-11.19), when compared to those with ALDH2*1/*1. The increased risk of esophageal cancer was made greater, when subjects carried both ADH2*1/*1 and ALDH2*1/*2, compared to those with ADH2*1/*2 or ADH2*2/*2 and ALDH2*1/*1 (AOR = 36.79, 95%CI = 9.36-144.65). Furthermore, we found a multiplicative effect of lifetime alcoholic consumption and genotypes (ADH2 and ALDH2) on esophageal cancer risk. CONCLUSION: Our findings suggest that polymorphisms of ADH2 and ALDH2 can modify the influence of alcoholic consumption on esophageal cancer risk.