A recent case–control study involving 160 pancreatic cancer patients and 800 age- and sex-matched controls in Japan found that alcohol consumption was associated with increased risk in individuals with the ALDH2 Lys+ allele or ADH1B His/His or ADH1C Arg/Arg genotypes, but not in those with the ALDH2 Glu/Glu genotype or ADH1B Arg or ADH1C Gln alleles.46 This suggests that the risk of pancreatic cancer is associated with the combined effect of alcohol consumption and certain polymorphisms in alcohol-metabolizing enzymes. This evidence concerns the gene ALDH2 and familial pancreatic carcinoma.