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We talk to DPhil student Becky Im about her investigations into oesophageal cancer risks in Asian populations

As part of oesophageal cancer focus month, we spoke to DPhil student Pek Kei (Becky) Im, who is studying with the China Kadoorie Biobank research group, under Professor Zhengming Chen, Dr Iona Millwood and Dr Ling Yang, at the Nuffield Department of Population Health.

Many genetic and environmental factors can increase a person’s risk of cancer, and it is well-known that alcohol consumption is associated with an increased risk of certain cancers such as oesophageal and liver. However existing evidence is mainly based on Western populations and remains inconclusive for many cancer types.


At present, similar research is limited from China, where cancer rates, drinking patterns and individuals’ tolerability of alcohol have important cultural and biological differences when compared to Western populations.

The China Kadoorie Biobank is a very important resource, which contains information on over 510,000 adults recruited from ten rural and urban areas in China during 2004-2008. It is a result of a joint initiative and collaboration between Oxford’s Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU) and the Chinese Academy of Medical Sciences (CAMS). Using big data like this, which contains numerous data sets such as lifestyle, genetic and demographic information, can help to determine genetic and environmental causes of common chronic diseases in a population.

Becky’s primary research interest is in the effect of health behaviours, in particular alcohol drinking, on the wellbeing and health outcomes of Chinese populations.

Using the biobank data, Becky is currently looking at relationship between alcohol consumption patterns and risk of developing oesophageal cancer over a ten-year period in half a million Chinese adults, alongside the influence that genetics may also have. It is common in people from East Asian populations to have an ‘alcohol flush reaction’, a genetic condition in which a person develops flushes after drinking due to a reduced ability to break down a toxic metabolite of alcohol called acetaldehyde, which is speculated to further affect the risk of oesophageal cancer.

Early results from Becky’s work currently suggests, like in Western populations, certain alcohol consumption characteristics (such as high intake) can increase risks of oesophageal cancers in Chinese population, alongside other cancers. Moreover, those with alcohol flush responses may also be linked to an increased oesophageal cancer risk.

Results and conclusions of Becky’s initial work will be published later this year, but the implications of this research will help to demonstrate that certain drinking patterns and genetic makeup should be considered when determining the susceptibility to cancer development in East Asian populations.

Becky Im says:

“Alcohol consumption has markedly increased in China since the 1980s and it has emerged as a national health problem as those in Western countries.

“Knowing the effects of alcohol drinking, in various aspects which differ across populations and cultural subgroups, on oesophageal cancer and also other cancers provides timely evidence to inform health policy on cancer prevention and future research opportunities in China and elsewhere.”