ARTICLE ABSTRACT
Alcoholic beverages and the main metabolite of alcohol, acetaldehyde, are known carcinogens. A genetic variant in aldehyde dehydrogenase 2 (ALDH2, G>A, rs671) leads to decreased efficiency in metabolizing acetaldehyde and is associated with an increased cancer risk. As alcohol consumption is a modifiable risk factor for various cancers, the identification of ALDH2 deficiency presents an opportunity for precision cancer prevention.
Our primary objectives were to examine the prevalence of ALDH2 deficiency and alcohol consumption behavior among affected individuals within a large, diverse US national cohort. The prevalence of ALDH2 deficiency was determined by examining the rs671 genotype among 311,290 participants within the All of Us Research Program. Relationships among self-reported alcohol consumption, sociodemographic factors, and the rs671 genotype were analyzed.
ALDH2 deficiency was most prevalent among individuals who identified as Asian, among whom 23.5% had at least one deficient ALDH2 allele compared with <2.5% in all other racial/ethnic groups. Among those with one and two deficient ALDH2 alleles, 61.2% and 24.4% reported drinking in the past year, respectively, and of these, 30.3% and 16.0% reported binge drinking. Multivariable analysis showed that ALDH2 genotype, sex, age, race, education, income, employment, marital status, and country of birth were associated with alcohol consumption behavior.
Most individuals with ALDH2 deficiency reported drinking alcohol in the past year, and consumption was associated with various sociodemographic variables, particularly sex, age, and country of birth.
Our findings suggest a significant opportunity for precision cancer prevention targeting the unique prevalence of ALDH2 deficiency among Asian Americans.
