Annual U.S. cancer deaths attributed to alcohol consumption more than doubled between 1990 and 2023, rising from 11,361 to 23,126, according to a study published in The Lancet Regional Health — Americas. Researchers found that risks extend across multiple cancer types, with even light daily drinking increasing mortality odds, particularly for adults over 55.
Annual cancer deaths in the United States tied to alcohol consumption more than doubled over a three-decade period, driven by growing mortality rates across a wide range of malignancies rather than liver disease alone.
The study, which utilized three decades of data from the Global Burden of Disease study, was led by researchers at the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine. Findings were published in The Lancet Regional Health — Americas and presented at the American Society of Clinical Oncology Annual Meeting in Chicago.
The Surprising Breadth of Alcohol-Attributable Cancers Beyond the Liver
While public health campaigns have traditionally focused on liver damage, researchers discovered that alcohol acts as a risk factor for a much broader array of malignancies. The analysis linked alcohol consumption to deaths from colorectal, esophageal, breast, stomach, pancreatic, prostate, and head and neck cancers.
“The most surprising finding was the breadth of alcohol’s potential impact across cancer types,”
Dr. Jani added that while the relationship with liver cancer is widely recognized, the public less understands alcohol’s contribution to cancers such as colorectal, esophageal, breast, pancreatic and prostate cancer.
Public awareness regarding these wider links remains limited, despite alcohol being classified as a Group 1 carcinogen by the International Agency for Research on Cancer. This classification places it in the same risk category as tobacco smoke and asbestos.
According to the National Cancer Institute, alcohol consumption accounted for roughly 5%—nearly 100,000—of all U.S. cancer diagnoses in 2019, and was responsible for about 4%, or nearly 25,000, of cancer deaths that year. Furthermore, researchers point out that even relatively low intake levels of 5 to 15 grams per day can elevate cancer risk. With the Centers for Disease Control and Prevention defining a standard U.S. drink as containing 14 grams of pure alcohol, just one drink per day could increase the risk of becoming part of those statistics.
Demographic Burdens: Older Adults and Changing Trends in Younger Cohorts
The burden of alcohol-related cancer mortality is not distributed evenly across the population. Older adults and men face the highest overall impact.
In 2023, adults aged 55 and older accounted for 19,460 of the 23,126 alcohol-attributable cancer deaths, representing about 84 percent of the total. After researchers adjusted for the aging U.S. population, the alcohol-attributable cancer death rate rose from 3.8 to 4.1 per 100,000 people, marking a 7.6 percent increase. Adults 55 and older experienced roughly eight times the alcohol-attributable cancer death rate of adults between the ages of 20 and 54.
“Cancer takes a long time to develop, and cancer rates peak in your 60s. Given older adults have had a longer period of life exposed to alcohol, this is likely why we see this trend.”
Among older men, liver cancer represented the primary cause of alcohol-related mortality, followed closely by esophageal and colorectal cancers. Among women aged 55 and older, breast cancer served as the leading alcohol-linked cancer killer, followed by liver and colorectal cancers. For women overall, breast cancer remained the leading cause of alcohol-related cancer death throughout the study period.
Among younger adults aged 20 to 54, colorectal cancer emerged as the leading cause of alcohol-attributable cancer deaths for men and the second leading cause for women, surpassing liver cancer in both demographics.
Public Health Messaging and Modifiable Risk Factors
Because no minimum safe level of alcohol has been firmly established for cancer prevention, medical professionals emphasize that reducing consumption can serve as an effective strategy for lowering long-term risk.
The study’s authors noted that because their research utilized existing national data rather than following individual patients over time, it could not determine exact lifetime drinking habits or account for every lifestyle variable. Consequently, the findings establish a strong association between alcohol use and cancer deaths but cannot definitively prove direct causation in individual cases.
Even so, public perception appears to be shifting.
“What this study makes clear is that alcohol-related cancer risk is not limited to one disease or one group of people. As physicians and cancer researchers, we have an opportunity to help patients understand that alcohol is a modifiable risk factor and that even small, informed changes can be part of a broader strategy to reduce cancer risk in our community.”
