Alcohol-attributable cancer deaths in the United States doubled between 1990 and 2023, according to a study led by researchers at the Sylvester Comprehensive Cancer Center. Annual deaths rose from 11,361 in 1990 to 23,126 in 2023, representing a 103 percent increase.
The research, published Aug. 2 in The Lancet Regional Health – Americas and first presented at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, utilized more than three decades of Global Burden of Disease data. While the link between alcohol and liver cancer is well established, the study found that alcohol’s impact extends to a wide array of other malignancies.
Broad Impact Across Cancer Types
Researchers analyzed 10 different forms of cancer, including pancreatic, prostate, breast, colorectal, stomach, esophageal, larynx, pharynx, and cancers of the lip and oral cavity. Dr. Chinmay Jani, the study’s corresponding author and chief fellow in hematology and oncology at Sylvester, stated that the breadth of alcohol’s potential impact across cancer types
was the most surprising finding.
When looking at combined data for all sexes, alcohol-related deaths increased for every cancer studied except liver cancer. The most significant increases were observed in deaths from stomach cancer (57 percent), followed by pancreatic cancer (40.5 percent) and colorectal cancer (39.7 percent).
Demographic and Geographic Trends
The highest burden of alcohol-attributable cancer deaths was found among men and adults aged 55 and older. However, the research highlighted specific trends among adults aged 20 to 54:
- Men (20-54): Colorectal cancer was the leading cause of alcohol-attributable cancer mortality, followed by esophageal cancer.
- Women (20-54): Breast cancer ranked as the first leading cause, followed by colorectal cancer.
Dr. Jani noted that for both men and women in this 20-to-54 age group, colorectal cancer surpassed liver cancer as a leading cause of alcohol-attributable mortality. Among older men, liver cancer remained the leading cause, followed by esophageal and colorectal cancers, while breast cancer was the most common form among older women.
The study also identified substantial geographic variation within the U.S. In 2023, Washington, D.C., recorded the highest alcohol-attributable cancer mortality rates, whereas Utah recorded the lowest. Researchers noted the findings are particularly relevant for Florida due to its large population of older adults, the group experiencing the highest mortality rates.
Risk Factors and Prevention
The International Agency for Research on Cancer classifies alcohol as a Group 1 carcinogen, a category that includes asbestos and tobacco smoke. Experts suggest that when the body breaks down alcohol, it creates acetaldehyde, a toxic chemical that destroys healthy cells and creates an environment where cancer cells can thrive.
The study authors highlighted that elevated cancer risk is linked to intake levels as low as 5-15 grams per day. For context, the Centers for Disease Control and Prevention defines a “standard drink” in the U.S. as 14 grams of pure alcohol (0.6 ounces).
Dr. Gilberto Lopes, senior author and chief of the Division of Medical Oncology at Sylvester, emphasized that alcohol is a modifiable risk factor
and that small, informed changes can help reduce cancer risk in the community. Despite the evidence, the researchers noted that public awareness of the link between alcohol and cancer remains low compared to the awareness of tobacco use.
Study Limitations
The authors acknowledged certain limitations to the research, specifically the observational design of the database framework, which may have resulted in some incomplete data.
