The number of cancer deaths estimated to be attributable to alcohol in the United States doubled from 1990 to 2023, particularly among men and people aged 55 years and older, according to a University of Miami study published this month, adding to the body of recent research underscoring the health risks of alcohol consumption.
Around 23,126 people died of alcohol-attributable cancer in 2023, up from 11,361 in 1990, according to the study, which estimated the deaths using a global database of disease mortality and population-level estimates of alcohol exposure.
The impact of alcohol, a known carcinogen, increased over the past decades as cancer mortality decreased overall, according to the study.
“Even though overall the cancer mortality was going down for some of these cancers … alcohol associated mortality was going up,” said Chinmay Jani, a hematology-oncology fellow at the University of Miami and one of the authors of the study. “Which means that alcohol as a risk factor was impacting more cancer deaths in 2023 than it was in 1990.”
What cancers have been linked with alcohol consumption?
The breakdown of alcohol in the body produces chemicals that can damage DNA and cause cancer. Alcohol can also affect hormone levels, including estrogen, which can lead to breast cancer.
The leading causes of alcohol-attributable cancer deaths in 2023 were liver, esophageal and colorectal cancer, according to the study; the incidence of colorectal cancer in particular has increased among younger people in recent years, other studies have found.
For many cancers, the proportion of deaths attributed to alcohol increased over time, even as overall cancer mortality declined. The increases were more pronounced in people 55 or older.
While alcohol has been closely linked to several types of cancer, including mouth, throat, liver and breast cancer, its connections to other types of cancer like stomach and pancreatic cancer are still being investigated, researchers said. The study also found links between deaths from those cancers and alcohol use, which could warrant further research, Jani said.
The study also found large disparities in alcohol-related cancer deaths across states. Washington D.C. had the highest alcohol-attributable cancer mortality rate in 2023, while Utah had the lowest, according to the study. Previous studies have found links between states with less restrictive alcohol policies and higher shares of alcohol-related cancer deaths, the authors wrote.
Is there any ‘safe’ amount of alcohol?
Jani said that the study did not analyze individual-level data on alcohol consumption or confirm a reason for why alcohol-attributable cancer deaths increased.
Gilberto Lopes, a professor of clinical medicine at the University of Miami and another author of the study, added that the data did not establish a safe threshold for alcohol consumption.
“It is difficult to ascertain exactly what the safe level of alcohol is,” Lopes said. “[But] it is quite clear that we do know the mechanisms through which alcohol causes cancer. So that, there’s no dispute about.”
Other researchers have urged the tightening of U.S. drinking guidelines, a push that has drawn political controversy. A June study initially commissioned by the federal government found that having more than one drink a day can raise the risks of cancer and other illnesses, though the Department of Agriculture loosened its drinking guidelines in January.
Priscilla Martinez-Matyszczyk, a researcher at the Public Health Institute who co-authored the June study, said the University of Miami study did not examine the risks of people’s average daily alcohol intake but that its findings on alcohol-associated deaths supported previous research.
“These findings reinforce the growing literature that alcohol plays an important role in the cancer landscape,” she said.
Lopes said people should make their own decisions on alcohol consumption, but that everyone should be aware of its health risks.
“Our job as cancer doctors is not to tell adults how to live; it is to make sure they are making that decision with accurate information,” he said. “If someone wants to minimize their cancer risk from alcohol, less is better and none is best.”
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