Cancer deaths linked to alcohol have doubled in the U.S. over the past 30 years, increasing from just under 12,000 in 1990 to more than 23,000 in 2021, according to new research. The biggest rise was seen among men aged 55 and older.
This increase stands in sharp contrast to the overall trend in cancer deaths, which have dropped by about 35% during the same time period, data from the American Cancer Society shows.
The findings will be presented at the American Society of Clinical Oncology’s annual meeting in Chicago. They have not yet been published in a peer-reviewed journal.
Alcohol’s Role in Cancer
The study focused on seven types of cancers linked to alcohol use:
- Breast
- Liver
- Colorectal
- Throat
- Voice box (larynx)
- Mouth
- Esophagus
Alcohol is not responsible for all cases of these cancers, but it is a known risk factor in a significant number of them.
“People often don’t think of alcohol as a carcinogen like tobacco,” said Dr. Michael Siegel, a public health professor at Tufts University School of Medicine, who was not involved in the study.
But alcohol is classified as a carcinogen by the International Agency for Research on Cancer. Once inside the body, it breaks down into acetaldehyde, a toxic chemical also found in tobacco smoke. Acetaldehyde can damage DNA and make it easier for other carcinogens to affect the mouth and throat.
Growing Impact Over Time
In 1991, alcohol was linked to 2.5% of all cancer deaths in men and 1.46% in women. By 2021, those numbers rose to 4.2% for men and 1.85% for women.
Men saw a 56% increase in alcohol-related cancer deaths during this period. For women, the increase was nearly 8%.
“It wasn’t surprising that the rate was higher in men,” said Dr. Chinmay Jani, the study’s co-leader and a chief fellow at the University of Miami’s Sylvester Comprehensive Cancer Center. “But the size of the gap between men and women was unexpected.”
Historically, men have tended to start drinking at younger ages. However, newer studies suggest that more women are now drinking heavily, and slightly more young women binge drink than young men.
State-by-State Differences
Between 1991 and 2021, deaths from alcohol-related cancers rose among men in 47 states and in 16 states for women. New Mexico saw the highest increase in both men (60%) and women (18%). Oklahoma and Tennessee followed closely.
Some states, however, saw declines. Washington D.C. and New York had the largest decreases in men, while Massachusetts and New York showed drops for women. Utah had the lowest alcohol-related cancer death rates overall.
Older Adults Most at Risk
Cancer deaths related to alcohol were highest among people aged 55 and older. For men in this age group, deaths rose by more than 1% every year between 2007 and 2021.
“The damage doesn’t happen right away,” Jani explained. “But as people age and continue to drink, the risk builds over time.”
Among the seven cancers studied, liver, colorectal, and esophageal cancers were the deadliest in 2021. For men, liver cancer caused the most deaths. For women, it was breast cancer.
“Even small amounts of alcohol can affect breast tissue,” noted Dr. Jane Figueiredo, a medicine professor at Cedars-Sinai Medical Center, who was not involved in the study.
Possible Next Steps in Research
Dr. Jani said more research is needed to understand how alcohol affects different racial and ethnic groups. Some groups have lower levels of the enzyme that breaks down alcohol, causing higher acetaldehyde levels and possibly greater cancer risks.
Alcohol consumption in the U.S. peaked in the late 1970s, declined until the late 1990s, and then rose again. The COVID-19 pandemic also saw a sharp increase in alcohol use and alcohol-related deaths, according to the National Institute on Alcohol Abuse and Alcoholism.
Experts Call for Clearer Public Messaging
Experts say public awareness about alcohol’s cancer risks is lacking. A recent report by a former U.S. Surgeon General even recommended cancer warning labels on alcoholic drinks.
“It’s not about telling people not to drink,” Siegel said. “It’s about making sure they have the facts, not just assumptions.”
The World Health Organization has stated that there is no safe level of alcohol consumption when it comes to cancer risk.
