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Esophageal cancers have been relatively common for many years in negroid populations for various reasons. In Africa, mostly related to aflatoxins ingested with grain and nuts.

Japanese have had a higher incidence in Asian populations also over the years for various reasons as well. Asians (genetically) have a lower ADH enzyme activity than caucasians and this is also well known.

In caucasians (reported on the US population) esophageal cancer, related to Barrett's esophagitis is the cancer with fastest growing rate per year. Article published last week estimates a 500 fold increase per year in the US. All causes not clear but alcohol has been implicated as one of the most important. (This study did not make any reference to enzyme deficiency).

The same study, however, shows that 2 glases of red wine per day may actually be protective in patients with existing Barrett's esophagitis (pre-cancerous condition of the esophagus). This protective effect did not extend to beer drinkers or any other alcohol.

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