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Acetaldehyde, an ethanol metabolite, causally contributes to alcohol-related esophageal cancer. In Japan, many individuals carry the ALDH2*2 allele, reducing ALDH2 activity and increasing acetaldehyde exposure, thereby elevating risk. Dose–response effects have been reported among ALDH2*2 carriers. This study evaluates an unguided, web-based brief intervention integrating genetic cancer-risk education to reduce alcohol consumption in a randomized controlled trial.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/unguided-web-based-brief-intervention-with-genetic-risk-education-to-reduce-unhealthy-alcohol-consumption-in-japan-protocol-for-a-randomized-controlled-trial/352779/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/unguided-web-based-brief-intervention-with-genetic-risk-education-to-reduce-unhealthy-alcohol-consumption-in-japan-protocol-for-a-randomized-controlled-trial/352779.png","ImageObject",300,407,{"name":92,"@type":93},"Quinn Holloway","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-28","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the central rationale for the intervention in this protocol?","Question",{"text":112,"@type":113},"Alcohol consumption is linked to cancer risk, and acetaldehyde exposure drives alcohol-related esophageal cancer. The protocol leverages genetic cancer-risk education, targeting individuals who carry the ALDH2*2 allele to reduce alcohol intake.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What does the study aim to test?",{"text":117,"@type":113},"The project aims to evaluate the efficacy of an unguided, web-based brief intervention that incorporates genetic cancer-risk education to reduce alcohol consumption in a randomized controlled trial.",{"name":119,"@type":110,"acceptedAnswer":120},"Why can the study data not be broadly shared?",{"text":121,"@type":113},"Legal and ethical restrictions apply because the data may contain potentially identifying or sensitive patient information, and additional approval is required for secondary use.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},352779,1790658449,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},2336474466712,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","OPEN ACCESS  \nCitation: Kono Y, Tanaka-Sahker M, Kikuchi S, Luo Y, Sakata M, So R, et al. (2026) Unguided web-based brief intervention with genetic risk education to reduce unhealthy alcohol consumption in Japan: Protocol for a randomized controlled trial. PLoS One 21(4): e0347064. [https://doi.org/10.1371/journal](https://doi.org/10.1371/journal). pone.0347064  \nEditor: Annesha Sil, PLOS: Public Library of Science, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND  \nReceived: March 16, 2026  \nAccepted: March 24, 2026  \nPublished: April 17, 2026  \nPeer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: [https://doi.org/10.1371/journal](https://doi.org/10.1371/journal). pone.0347064  \nCopyright: © 2026 Kono et al. This is an open access article distributed under the terms of  \nSTUDY PROTOCOL  \nUnguided web-based brief intervention with genetic risk education to reduce unhealthy alcohol consumption in Japan: Protocol fora randomized controlled trial  \nYuki Kono1, Mai Tanaka-Sahker1, Shino Kikuchi2, Yan Luo3, Masatsugu Sakata4, Ryuhei So5,6,7,8, Tamara L. Wall9, Toshi A. Furukawa10, Ethan Sahker1*  \n1 Population Health and Policy Research Unit, Medical Education Center, Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, Japan, 2 Department of Gastroenterology and Metabolism, Graduate School of Medical and Pharmaceutical Sciences, Nagoya City University,  \n1 Kawasumi Mizuho-cho, Mizuho-ku, Nagoya, Japan, 3 Center for Medical Education and Internationalization, Kyoto University Graduate School of Medicine, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan, 4 Department of Neurodevelopmental Disorders, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi Mizuho-cho, Mizuho-ku, Nagoya, Japan, 5 CureApp, Inc. , Kodenma-Cho YS building floor, 12-5 Nihonbashi Kodenma-Cho, Chuo-ku, Tokyo, Japan, 6 Okayama Psychiatric Medical Center, 3-16 Shikata Honmachi, Kita-ku, Okayama City, Okayama, Japan, 7 Department of Health Promotion and Human Behavior, Graduate School of Medicine/ School of Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, Japan, 8 Scientific Research WorkS Peer Support Group (SRWSPSG), Osaka, Japan, 9 Department of Psychiatry, University of California, San Diego, Gilman Drive, La Jolla, California, United States of America, 10 Office of Institutional Advancement and Communications, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, Japan  \n* [sahker.ethan.2e@kyoto-u.ac.jp](sahker.ethan.2e@kyoto-u.ac.jp)  \nAbstract  \nBackground  \nAlcohol consumption is a major global contributor to morbidity and mortality and is a well-established risk factor for multiple cancers. Acetaldehyde, a toxic metabolite of ethanol, is a causal factor in alcohol-related esophageal cancer. A substantial proportion of the Japanese population carries the aldehyde dehydrogenase 2*2 (ALDH2*2) allele, which impairs ALDH2 enzymatic activity and increases acetaldehyde exposure, thereby elevating esophageal cancer risk. Among individuals with the ALDH2*2 allele, cancer risk demonstrates a clear dose–response relationship with alcohol consumption, with relative risks reported to be up to four times the relative risk, compared to non-carriers.  \nObjectives  \nThis project aims to evaluate the efficacy of an unguided, web-based brief intervention (BI) incorporating genetic cancer-risk education to reduce alcohol consumption ina randomized controlled trial.  \nPLOS One | [https://doi.org/10.1371/journal.pone.0347064](https://doi.org/10.1371/journal.pone.0347064) April 17, 2026 1 / 14  \nthe Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.  \nData availability s","cbCaicw7iQduO7dn","https://ap.wps.com/l/cbCaicw7iQduO7dn","pdf",959649,14,"English","# Background\n## Objectives\n## Data availability and ethics\n## Funding and competing interests","[{\"question\":\"What is the central rationale for the intervention in this protocol?\",\"answer\":\"Alcohol consumption is linked to cancer risk, and acetaldehyde exposure drives alcohol-related esophageal cancer. The protocol leverages genetic cancer-risk education, targeting individuals who carry the ALDH2*2 allele to reduce alcohol intake.\"},{\"question\":\"What does the study aim to test?\",\"answer\":\"The project aims to evaluate the efficacy of an unguided, web-based brief intervention that incorporates genetic cancer-risk education to reduce alcohol consumption in a randomized controlled trial.\"},{\"question\":\"Why can the study data not be broadly shared?\",\"answer\":\"Legal and ethical restrictions apply because the data may contain potentially identifying or sensitive patient information, and additional approval is required for secondary use.\"}]","Unguided web-based brief intervention with genetic risk education to reduce unhealthy alcohol consumption in Japan - Protocol for a randomized controlled trial | PDF",1790101359,35]