Alcohol-attributable cancer deaths in the U.S. have doubled since 1990, with rising risks across multiple cancer types and age groups, according to a study led by researchers at the University of Miami’s Sylvester Comprehensive Cancer Center.
Alcohol-linked deaths in the U.S. have doubled since 1990, with a surge in cases affecting not just liver cancer but also colorectal, breast, esophageal, and other cancers, a study led by the University of Miami’s Sylvester Comprehensive Cancer Center reveals. The findings, presented at the 2025 American Society of Clinical Oncology (ASCO) meeting and published in The Lancet Regional Health—Americas, highlight a growing public health crisis as alcohol’s role in cancer mortality expands beyond traditional associations.
Rising Deaths Across Cancer Types
The study analyzed global health data from 1990 to 2023, showing that alcohol-attributable cancer deaths rose from 11,361 to 23,126, with the fastest growth among adults aged 20 to 54. For men in this group, colorectal cancer became the leading cause of alcohol-related mortality, surpassing liver cancer. Among women, breast cancer ranked first, followed by colorectal cancer. The most surprising finding was the breadth of alcohol’s potential impact across cancer types,
said Dr. Chinmay Jani, corresponding author of the study and chief fellow in hematology and oncology at Sylvester. Although its relationship with liver cancer is widely recognized, its contribution to cancers such as colorectal, esophageal, breast, pancreatic and prostate cancer is less well understood by the public.
Geographic disparities also emerged, with Washington, D.C., reporting the highest alcohol-attributable cancer mortality rates in 2023, while Utah had the lowest. The study emphasized that alcohol’s carcinogenic effects are not limited to a single organ or demographic. What this study makes clear is that alcohol-related cancer risk is not limited to one disease or one group of people,
said Dr. Gilberto Lopes, senior author and chief of the Division of Medical Oncology at the Miller School. As physicians and cancer researchers, we have an opportunity to help patients understand that alcohol is a modifiable risk factor.
Public Awareness Gaps and Communication Challenges
Despite the growing data, public awareness of alcohol’s cancer risks remains alarmingly low. A separate study published in Cancer found that messages about alcohol and cancer are more effective when they name specific cancers and include visual aids, such as AI-generated images of health consequences. Many people remain unaware that alcohol is linked to several cancers,
said Dr. Taghrid Asfar, a professor of public health sciences at the University of Miami. Our findings suggest that clear, evidence-based communication, particularly when it includes specific information about cancer risk, may be a useful way to improve public understanding of this important health issue.
The research also revealed that moderate drinkers were more responsive to these messages than heavy drinkers, who were less likely to engage. Effective cancer prevention communication must be tailored to where people are psychologically— their readiness to adopt behavioral changes and their understanding of the relative risks involved,
said Frank Penedo, director of the Sylvester Survivorship and Supportive Care Institute at the University of Miami. This study underscores the importance of testing messages so we can better understand what captures attention, what builds trust and what may help people make informed decisions about their health.
Experts warn that misconceptions persist, with many people still viewing alcohol as less harmful than tobacco. People don’t necessarily think of alcohol as a carcinogen,
said Dr. Michael Siegel, a professor of public health at Tufts University School of Medicine, also not involved in the study. “But it is.” Alcohol’s carcinogenic effects stem from its breakdown into acetaldehyde, a toxic compound that damages DNA, and its ability to weaken the body’s cell-repair mechanisms. We know even small amounts of alcohol can influence breast tissue and increase risk,
added Dr. Jane Figueiredo, a professor of medicine at the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center, who was not involved in the research.
What Comes Next: Policy, Education, and Prevention
The findings call for stronger public health strategies to address alcohol-related cancer risks. Researchers emphasize that current warnings—such as those on tobacco products—could serve as a model for alcohol.
Dr. Jani and his team plan to examine how alcohol affects cancer risk across different racial and ethnic groups, as drinking patterns and healthcare access vary widely. Our goal is not simply to tell people that alcohol can increase cancer risk, but to understand how to communicate that information in ways people notice, trust and remember,
Asfar said. The study’s authors also stress the need for targeted education, especially among younger adults, who are increasingly engaging in heavy drinking. You might not feel the impact when you’re younger, but continued drinking over the years allows carcinogens to accumulate and cause long-term damage,
Jani explained.
As the research underscores, addressing alcohol’s role in cancer requires a multifaceted approach. From refining public messaging to advocating for policy changes, the next steps will depend on translating these findings into actionable strategies. For now, the message is clear: alcohol is a modifiable risk factor with far-reaching consequences, and the time to act is now.
