The interplay between alcohol consumption, oral hygiene, ALDH2and ADH1B in the risk of head and neck cancer

Sen Tien Tsai, Tung Yiu Wong, Chun Yen Ou, Sheen Yie Fang, Ken Chung Chen, Jenn Ren Hsiao, Cheng Chih Huang, Wei Ting Lee, Hung I. Lo, Jehn Shyun Huang, Jiunn Liang Wu, Chia Jui Yen, Wei Ting Hsueh, Yuan Hua Wu, Ming Wei Yang, Forn Chia Lin, Jang Yang Chang, Kwang Yu Chang, Shang Yin Wu, Hsiao Chen LiaoChen Lin Lin, Yi Hui Wang, Ya Ling Weng, Han Chien Yang, Jeffrey S. Chang

Research output: Contribution to journalArticlepeer-review

63 Citations (Scopus)


Alcohol consumption is an established risk factor for head and neck cancer (HNC). The major carcinogen from alcohol is acetaldehyde, which may be produced by humans or by oral microorganisms through the metabolism of ethanol. To account for the different sources of acetaldehyde production, the current study examined the interplay between alcohol consumption, oral hygiene (as a proxy measure for the growth of oral microorganisms), and alcohol-metabolizing genes ( ADH1B and ALDH2) in the risk of HNC. We found that both the fast (∗2/∗2) and the slow (∗1/∗1 +∗1/∗2) ADH1B genotypes increased the risk of HNC due to alcohol consumption, and this association differed according to the slow/non-functional ALDH2 genotypes (∗1/∗2 +∗2/∗2) or poor oral hygiene. In persons with the fast ADH1B genotype, the HNC risk associated with alcohol drinking was increased for those with the slow/non-functional ALDH2 genotypes. For those with the slow ADH1B genotypes, oral hygiene appeared to play an important role; the highest magnitude of an increased HNC risk in alcohol drinkers occurred among those with the worst oral hygiene. This is the first study to show that the association between alcohol drinking and HNC risk may be modified by the interplay between genetic polymorphisms of ADH1B and ALDH2 and oral hygiene. Although it is important to promote abstinence from or reduction of alcohol drinking to decrease the occurrence of HNC, improving oral hygiene practices may provide additional benefit.

Original languageEnglish
Pages (from-to)2424-2436
Number of pages13
JournalInternational Journal of Cancer
Issue number10
Publication statusPublished - Nov 2014
Externally publishedYes


  • ADH1B
  • ALDH2
  • Case-control
  • Ethanol metabolism
  • Head and neck cancer
  • Oral hygiene

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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