Validation of Alcohol Flushing Questionnaire to Identify ALDH2 Status in a Case–Control Study of Head and Neck Cancer

Jenn Ren Hsiao, Wei Ting Lee, Chun Yen Ou, Cheng Chih Huang, Chan Chi Chang, Sen Tien Tsai, Ken Chung Chen, Jehn Shyun Huang, Tung Yiu Wong, Yu Hsuan Lai, Yuan Hua Wu, Wei Ting Hsueh, Shang Yin Wu, Chia Jui Yen, Jang Yang Chang, Chen Lin Lin, Ya Ling Weng, Han Chien Yang, Yu Shan Chen, Jeffrey S. Chang

Research output: Contribution to journalReview articlepeer-review

6 Citations (Scopus)


Background: Carriers of the ALDH2*2 allele have impaired alcohol metabolism and are more susceptible to the development of alcohol-related cancers, including head and neck cancer (HNC). Screening for ALDH2*2 allele may identify high-risk individuals for alcohol health education. Although genotyping of ALDH2 is the most accurate way to identify ALDH2 deficiency, it may not be practical due to the cost and requirement for genotyping service. Methods: This study evaluated the accuracy of the alcohol flushing questionnaire to identify ALDH2 deficiency in a case–control study of HNC conducted in Taiwan using data collected from 904 patients with HNC and 1,078 controls. Results: Overall, alcohol flushing questionnaire had a high sensitivity (89%) of identifying ALDH2*2 carriers among the control subjects and a good sensitivity (79%) among the patients with HNC. The sensitivity of the alcohol flushing questionnaire in identifying ALDH2*2 carriers was affected by alcohol use, with a lower sensitivity among individuals who consumed alcohol, particularly among current regular (drinking alcohol once per week or more) alcohol drinkers. Conclusions: The current validation study showed that the alcohol flushing questionnaire may be a reasonable method to identify ALDH2-deficient individuals. However, current regular users of alcohol who reported no alcohol flushing may need to undergo genotyping of ALDH2 for a more accurate assessment of the ALDH2 status.

Original languageEnglish
Pages (from-to)1225-1233
Number of pages9
JournalAlcoholism: Clinical and Experimental Research
Issue number6
Publication statusPublished - 2019 Jun

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Toxicology
  • Psychiatry and Mental health


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