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Alcohol may play a greater role in death from numerous types of cancers in the United States than previously known, according to a new study.
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“While it’s true that overall cancer mortality has declined, we found the percentage of cancer deaths proportionally attributable to alcohol doubled in people 20 and older over the last33 years,” said the study’s first author Dr. Chinmay Jani.
The increased risk of death applies to breast, prostate, colon, rectum, stomach, pancreatic and liver cancers, as well as cancers of the head and neck, the research found.
“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.”
It didn’t take much alcohol to raise one’s risk — about one standard drink a day, every day, Jani said. In the US, a standard drink is 12 ounces of regular beer, 5 ounces of wine or 1.5 ounces of 80-proof liquor.
For decades, federal guidelines have recommended that Americans limit their drinking to two standard drinks a day for men and one drink a day for women. In January, the Trump administration removed those limits, instead suggesting that people should “consume less alcohol for better overall health.”
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While having a cocktail each evening was once considered to be an acceptable part of daily life, studies today show that’s an outdated belief, said cardiologist Dr.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 was not involved with the new research. “This study in concert with several others suggests that the risks associated with consumption need much wider recognition.”
How alcohol contributes to cancer growth
Alcohol contributes to cancer growth in several ways, according to the National Cancer Institute, or NCI. Alcohol alters levels of hormones, including estrogen, a key reason for the link between drinking and breast cancer.
Alcohol is ethanol or ethyl alcohol, which is broken down by the liver into acetaldehyde, a “probable human carcinogen,” the NCI states on its website. While the liver will further break down acetaldehyde into a harmless molecule called acetate, the process isn’t foolproof: acetaldehyde may damage DNA and interfere with DNA repair before conversion into acetate is complete.
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Alcohol also contributes to oxidative stress, which damages DNA, proteins and cell function and creates inflammation. Drinking alcohol also weakens the cells in the mouth and throat, making them more susceptible to carcinogens. That’s even more likely to occur with smoking cigarettes, a major source of acetaldehyde.
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In addition, alcohol interferes with the break down and absorption of key nutrients thought to decrease cancer risk — vitamins A, C, D and E as well as folates in the vitamin B complex, according to NCI.
Effects may differ by age and sex
The study, which was published Monday in The Lancet Regional Health – Americas journal,analyzed more than three decades of US data gathered for the Global Burden of Disease Study. The GBD study is a massive scientific effort to measure health, mortality and disabilities from hundreds of risk factors, diseases and conditions in more than 200 countries and territories.
Between 1990 and 2023, the total number of yearly alcohol-linked cancer deaths more than doubled, rising from 11,361 to 23,126 in the US.
Men and adults age 55 and older experienced the greatest impact; alcohol-related cancer mortality rate in older malesclimbed nearly 24% over the 33-year period. For men, liver cancer deaths showed the strongest link to alcohol, followed by esophageal and colorectal cancers. For women 55 and older, breast cancer was the top killer, followed by liver and colorectal cancers.
For women of any age, and for men younger than age 55, it takes less alcohol to raise of risk of cancer compared with men older than 55, according to Jani. “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.
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Of the 10 cancers the study examined, the smallest increases in alcohol-linked deaths were in prostate, pancreatic and stomach cancers, but even those went up over time, Jani said.
Alcohol played a major role in deaths from malignant tumors in the head and neck, including lip, oral cavity, pharynx, larynx and cancer of the esophagus. Up to one-fourth of head and neck cancers have alcohol as a risk factor, “which obviously could be prevented,” Jani said.
“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.”
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