Alcohol may be a bigger factor in deaths from many types of cancer in the US than has been recognized until now, a new study suggests.
“While it’s true that overall cancer mortality has declined, we found the percentage of cancer deaths proportionally attributable to alcohol rose over 58% in people 20 and older over the last 33 years,” said the study’s first author Dr. Chinmay Jani.
This elevated death risk shows up in cancers of the breast, prostate, colon, rectum, stomach, pancreas and liver, along with head and neck cancers, according to the research.
“Overall, we know alcohol is closely related to liver cancer mortality,” said Jani, chief clinical fellow in hematology and oncology at the Sylvester Comprehensive Cancer Center of the University of Miami.
“Notably, among adults aged 20 to 54, colorectal cancer was the leading cause of alcohol-attributable cancer mortality in men and the second leading cause in women, surpassing liver cancer in both groups,” he said. “In women, the leading cause was alcohol-related breast cancer.”
The risk climbs with surprisingly little alcohol — roughly one standard drink daily, Jani said. In the US, a standard drink equals 12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor.
For decades, federal guidance capped recommended drinking at two standard drinks a day for men and one for women. That changed in January, when the Trump administration dropped those specific limits and instead advised people to simply “consume less alcohol for better overall health.”
The idea of a nightly drink being a harmless daily habit is now outdated, according to cardiologist Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver.
“What we used to think about alcohol continues to be eroded as modern science has shown us that there is no safe amount of alcohol consumption,” said Freeman, who had no involvement in the new study. “This study in concert with several others suggests that the risks associated with consumption need much wider recognition.”
The Distilled Spirits Council of the United States, an industry group, pushed back in a statement emailed to CNN, saying the claim that “there is ‘no safe level’ of alcohol consumption is not supported by this study.”
“It misrepresents the body of scientific evidence and the complex relationship between alcohol and health,” said Amanda Berger, senior vice president of science and research for the Council.
How alcohol fuels cancer growth
Alcohol promotes cancer through multiple pathways, according to the National Cancer Institute (NCI). It shifts hormone levels, including estrogen, which helps explain its connection to breast cancer.
Alcohol — chemically ethanol — gets broken down by the liver into acetaldehyde, which the NCI identifies as a “probable human carcinogen.” The liver eventually converts acetaldehyde into a harmless compound called acetate, but that process isn’t perfect: before the conversion finishes, acetaldehyde can damage DNA and interfere with the body’s ability to repair it.
Alcohol also drives oxidative stress, which harms DNA, proteins and cell function while triggering inflammation. It weakens cells in the mouth and throat too, leaving them more vulnerable to carcinogens — a risk that grows sharply when combined with smoking, itself a major acetaldehyde source.
On top of that, alcohol disrupts the breakdown and absorption of nutrients believed to lower cancer risk, including vitamins A, C, D and E, as well as B-complex folates, per the NCI.
Effects may differ by age and sex
Published Monday in The Lancet Regional Health – Americas, the study drew on more than 30 years of US data collected as part of the Global Burden of Disease Study — a large-scale effort tracking health outcomes, deaths and disability tied to hundreds of risk factors and conditions across over 200 countries and territories.
From 1990 to 2023, annual alcohol-linked cancer deaths in the US more than doubled, going from 11,361 to 23,126.
Men and adults 55 and older were hit hardest; among older men, the alcohol-related cancer death rate rose nearly 24% over the three decades. In men, liver cancer had the strongest tie to alcohol, followed by esophageal and colorectal cancers. Among women 55 and older, breast cancer topped the list, followed by liver and colorectal cancers.
Jani noted that women of any age, and men under 55, face a higher cancer risk from the same amount of alcohol compared with men over 55. “If the same proportion of alcohol is taken by a female or by a younger male or female, it’s considered a much higher risk potential for cancer development,” he said.
Among the 10 cancers studied, alcohol-related deaths rose least for prostate, pancreatic and stomach cancers — though even these increased over time, Jani said.
Alcohol was a major factor in deaths from head and neck tumors, including cancers of the lip, oral cavity, pharynx, larynx and esophagus. As much as a quarter of head and neck cancers list alcohol as a risk factor — cases Jani noted are “obviously” preventable.
“While our study does not have the data to show you should completely stop drinking alcohol, the message we want to deliver is that lowering your alcohol use to the lowest possible level will be best for your health.”
