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East Asians more likely to develop stomach cancer because of lower alcohol tolerance, new study says

The inability to properly process alcohol enables it to sit in the stomach for a long time, making frequent drinkers more likely to develop chronic stomach inflammation, one researcher said.
A pub in Tokyo on Sept. 6, 2019.
A pub in Tokyo in 2019.Shiho Fukada / Bloomberg via Getty Images file

East Asian people are more likely to develop a more aggressive type of stomach cancer because of their higher likelihood of alcohol intolerance, according to a new study led by researchers in Japan.

The researchers’ findings, published this week in the scientific journal Nature Genetics, associate lower alcohol tolerance with higher risk of diffuse stomach cancer, a rarer type of gastric cancer that affects more than one area of the stomach.

Dr. William Dahut, chief scientific officer of the American Cancer Society, said the study — which collected cells from nearly 1,500 stomach cancer patients in Japan, China, South Korea, Singapore and the U.S. — is the first extensive genomic analysis of gastric cancer.

“There is an interesting combination between mutation development and a specific genotype in East Asians, which interferes with alcohol metabolism,” Dahut, who was not involved in the study, said. “It seems like having that genotype, they’re more likely to develop a specific mutation of the tumor.”

Populations in East Asia have long been disproportionately affected by stomach cancer compared to those of Western countries. Half of all gastric cancer cases worldwide occur in China, and it is the most common type of cancer among men in Japan. Yet in the United States, gastric cancer accounts for only about 1.5% of all new cancers diagnosed per year.

People of East Asian heritage are much more likely to inherit a genetic mutation not commonly seen in other ethnic groups that compromises the ability to metabolize alcohol. This is the same mutation responsible for the facial redness after drinking often referred to as “Asian glow,” according to study co-author Tatsuhiro Shibata.

Shibata, who heads the Division of Cancer Genomics at Japan’s National Cancer Center Research Institute, said he hopes these findings make it easier for researchers to detect patterns in the onset of stomach cancer.

“We may develop some specific way to detect areas and maybe prevent certain cancers,” he said.

Many East Asians’ inability to properly process alcohol enables it to sit in the stomach for a long time, making frequent drinkers more likely to develop chronic gastritis, said Ajay Goel, who researches gastrointestinal cancer detection at City of Hope Medical Center in California and was not involved with the new research.

“That leads to essentially chronic inflammation within the stomach,” Goel said. “And eventually, over years and years of repeated exposure, these patients tend to get increased incidence of gastric cancer.”

Cases of gastric cancer are also statistically much more common in men than in women. But this makes sense from a behavioral perspective, Goel said, rather than being due to any inherent genetic factors. Data show East Asian men tend to consume significantly more alcohol than their female counterparts.

As with any type of cancer, early detection is crucial to treating stomach cancer. But due to its relative infrequency in the West compared to other types, such as breast, cervical and colon cancer, the United States does not routinely screen for gastric cancer.

“It’s increasingly important information on the power of knowing one’s own genomics,” Dahut said.