A drink with dinner may seem routine, but new research is putting fresh attention on how alcohol can shape cancer risk over time. According to the University of Miami Miller School of Medicine, researchers found that annual alcohol attributable cancer deaths in the United States increased from 11,361 in 1990 to 23,126 in 2023. The study, published September 2 in The Lancet Regional Health Americas, used more than three decades of Global Burden of Disease data to examine mortality connected to alcohol across multiple cancers, age groups and regions.
“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 last 33 years,” study author Dr. Chinmay Jani told CNN.
The alcohol cancer risk identified by researchers extended far beyond liver disease. According to the University of Miami research team, rising burdens were seen across colorectal, breast, esophageal, pancreatic and other cancers. Men and adults 55 and older carried the greatest overall burden.
“Overall, we know alcohol is closely related to liver cancer mortality,” Jani added.
The picture looked different among younger adults. According to the University of Miami study, colorectal cancer was the leading alcohol attributable cancer death among men ages 20 to 54. Among women in the same age range, breast cancer ranked first, and colorectal cancer ranked second.
“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,” Jani said. “In women, the leading cause was alcohol-related breast cancer.”
The findings matter because alcohol cancer risk is not limited to people who drink heavily. Jani told CNN that about one standard drink a day was enough to raise risk. According to the National Cancer Institute, a standard U.S. drink contains about 14 grams of pure alcohol, generally equal to 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor.
The current U.S. dietary guidance has also changed. The National Institute on Alcohol Abuse and Alcoholism says the 2025 to 2030 Dietary Guidelines now recommend that Americans “consume less alcohol for better overall health.” Unlike the previous guidelines, the current recommendations do not provide separate daily drink limits for men and women.
Cardiologist Dr. Andrew Freeman, who was not involved in the latest study, told CNN the broader scientific conversation around drinking has shifted significantly.
“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,” Freeman said. “This study in concert with several others suggests that the risks associated with consumption need much wider recognition.”
That conclusion did not emerge from one study alone. Alcohol cancer risk has been documented across decades of research.
A 2013 meta-analysis published in Annals of Oncology examined 222 articles involving roughly 92,000 light drinkers with cancer and 60,000 nondrinkers with cancer. According to the study record in PubMed, drinking up to one alcoholic beverage per day was associated with increased risks of cancers of the oral cavity and pharynx, esophageal squamous cell carcinoma, and female breast cancer.
A larger 2015 analysis published in the British Journal of Cancer examined 572 studies involving 486,538 cancer cases. According to the published research, investigators found clear dose-related increases in risk for cancers including the oral cavity, pharynx, esophagus, colorectum, larynx and female breast. The researchers also reported higher risks of several additional cancers among heavy drinkers.
Global evidence has reinforced those findings. A 2021 population study published in The Lancet Oncology estimated that 741,300 new cancer cases worldwide in 2020, or about 4.1 percent of all new cases, were attributable to alcohol. According to the Lancet study, moderate drinking accounted for an estimated 103,100 of those cases, while consumption of up to 10 grams of alcohol per day was associated with an estimated 41,300 cases.
The federal government has also elevated the issue. According to the U.S. Surgeon General’s alcohol and cancer advisory, scientific evidence establishes a causal connection between alcohol consumption and at least seven cancers, including female breast, colorectal, esophageal, liver, mouth, throat, and laryngeal cancers. The advisory identified alcohol as one of the leading preventable causes of cancer in the United States.
Researchers have several explanations for the alcohol cancer risk. According to the National Cancer Institute, the body converts ethanol into acetaldehyde, a “probable human carcinogen” that can damage DNA and proteins. Alcohol can also create oxidative stress, interfere with the absorption of certain nutrients, and increase estrogen levels, which is one reason researchers have studied its connection to breast cancer.
The International Agency for Research on Cancer first classified alcoholic beverages as carcinogenic to humans in 1987. IARC later added colorectal and female breast cancer to the cancers causally connected to alcohol and has found evidence that stopping alcohol consumption can reduce the incidence of oral cavity and esophageal cancers.
Age and biological sex may also influence risk. “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,” Jani told CNN.
The latest research also found alcohol played an important role in cancers affecting the head and neck, including the lip, oral cavity, pharynx, larynx and esophagus. Jani said as many as one-fourth of head and neck cancers have alcohol as a risk factor, “which obviously could be prevented.”
Because the new study is a secondary analysis of population data, it estimates the burden of alcohol attributable mortality rather than predicting exactly what will happen to an individual who drinks. Still, its findings join years of studies showing that alcohol cancer risk generally rises as consumption increases and can be measurable even at relatively low levels.
“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.”
