To investigate the relationship among alcohol dehydrogenase-2 (ADH2) and aldehyde dehydrogenase-2 (ALDH2) genetic polymorphisms, alcohol consumption and the susceptibility to esophageal cancer in a Chinese population, we conducted a case-control study with 221 cases and 191 population-based controls in the Taixing city of Jiangsu Province of China. ADH2 and ALDH2 genotypes were examined using PCR and denaturing high-performance liquid chromatography. Alcohol drinkers with the ALDH2 A allele showed a significantly increased risk of esophageal cancer compared with drinkers with the ALDH2 G/G genotype (odds ratio (OR)¼3.08, 95% confidence interval ( Keywords: alcohol dehydrogenase 2; aldehyde dehydrogenase 2; alcohol drinking; case-control study; esophageal cancer INTRODUCTION Epidemiological studies have consistently shown that alcohol drinking is a risk factor for esophageal cancer. 1 When ethanol is consumed, it is metabolized primarily by alcohol dehydrogenase (ADH) into acetaldehyde, an intermediate metabolite, and then it is metabolized by aldehyde dehydrogenase (ALDH) into acetic acid. 2 Acetaldehyde, a well-known carcinogen in animals, has an important role in alcohol toxicity in humans. 3 Most studies, conducted mainly in Japan, have revealed associations between the ADH2 or ALDH2 polymorphism and esophageal cancer risk. [4][5][6][7][8] found that Chinese alcoholic patients with the ADH2 G and ALDH2 A alleles were more susceptible to esophageal cancer. Wu et al. 10 also found a multiplicative effect of lifetime alcoholic consumption and genotypes (ADH2 and ALDH2) on esophageal cancer risk, but those were only found in Taiwanese males.Taixing City, located in the middle part of Jiangsu Province, China, has relatively high incidence and mortality rates for esophageal cancer