A shocking new study finds the number of alcohol-related deaths in the US has nearly doubled in the last two decades.
This is the first study to look at long-term trends in alcohol-linked cancer deaths across the country and was led by a team from the Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine.
But not every demographic has been hit equally.
Alcohol — classified as a Group 1 carcinogen by the International Agency for Research on Cancer — is the third-leading preventable cause of cancer in the United States, after tobacco and obesity.
Earlier this year, the former US Surgeon General, calling for a warning label to be placed on alcoholic products, issued an advisory cautioning Americans of the strong link between alcohol consumption and an increased risk for “at least seven types of cancer,” including breast, colon and liver.
In this new study published in the Journal of Clinical Oncology, researchers used data from the Global Burden of Disease database to understand how alcohol use contributes to cancer-related deaths.
Their research revealed that in the U.S. between 1990 and 2021, the total number of alcohol-related cancer deaths nearly doubled, from just under 12,000 deaths per year to just over 23,000.
“That’s a big and concerning rise. We need to increase awareness of this link among the general population and even in the medical field,” said Sylvester hematology and oncology fellow Dr. Chinmay Jani, who led the study.
Jani noted that while there is widespread awareness about the relationship between tobacco and increased cancer risk, there is less recognition of the link between alcohol and cancer.
A 2024 report by the American Association for Cancer Research found that while more than 5% of all cancer cases are caused by drinking alcohol, 51% of Americans are not aware that alcohol increases cancer risk.
Researchers reviewed total cancer deaths, as well as those linked to alcohol consumption: breast, liver, colorectal, throat, voice box, mouth, and esophageal cancers.
Jani and his team found that the cancer mortality burden was especially high in men 55 and over, whose alcohol-linked cancer mortality rose slightly more than 1% every year from 2007 to 2021.
The increase in alcohol-related cancer mortality rates is owed nearly entirely to an increase among men. In women, rates have actually slightly declined since 1990.
However, even for cancers with declining mortality rates, the proportion caused by alcohol for nearly all of them rose between 1990 and 2021, for both men and women.
Among all cancers combined, the percentage of cancer deaths due to alcohol consumption increased by nearly 50% between 1990 and 2021, meaning even if factors like improved screening and treatment are reducing cancer deaths, alcohol consumption is responsible for a larger percentage of cancer mortality than in the past.
Liver, colorectal, and esophageal cancers saw the most significant increases in alcohol-related mortality.
On a state level, Texas and the District of Columbia had the highest rates of alcohol-linked cancer mortality, while Utah had the lowest.
Researchers think these differences could reflect regional differences in drinking cultures, as well as socioeconomic disparity and variances in health access.
According to the Surgeon General, alcohol is responsible for 100,000 cancer cases and 20,000 cancer deaths in the country each year.
1 in 6 breast cancer cases can be attributed to alcohol.
There are a few ways that drinking can contribute to an increased likelihood of developing cancer.
One is acetaldehyde, a known carcinogen that the body creates when it breaks down the ethanol in alcohol. This compound damages DNA and prevents cells from repairing the damage, allowing cancerous cells to grow.
It can also impact hormones, which affect how cells grow and divide. When that goes wrong, there’s room for cancer to develop. Moreover, drinking interferes with the body’s ability to absorb nutrients like iron, selenium, folate, and vitamins A, B1, B6, C, D, E, and K.
Excess alcohol intake can contribute to weight gain, and being overweight or obese has been linked with a higher risk of getting 13 types of cancer, including those in the breasts, liver, ovaries, kidneys, thyroid, and colon and rectum.
“We hope that our study will help educate the public on the impact of alcohol on individual cancer risk, as this is a potentially modifiable factor,” said Gilberto Lopes, M.D., Sylvester’s chief of the Division of Medical Oncology and the study’s senior author.
In addition to reducing or eliminating alcohol consumption, experts recommend other modifiable factors such as quitting tobacco, eating more green, leafy vegetables and whole grains, reducing or eliminating highly processed foods, maintaining a healthy body weight, and being physically active, all of which can lower cancer risk.
For those who choose to consume alcohol, the 2020-2025 Dietary Guidelines for Americans suggests limiting intake to no more than one drink per day for women and two drinks per day for men.
