Alcohol-attributable cancer deaths in the United States doubled between 1990 and 2023, according to a new study.
The findings, first presented as an oral presentation at the 2025 American Society of Clinical Oncology Annual Meeting and now appearing in The Lancet Regional Health—Americas, highlights alcohol as a potentially modifiable cancer risk factor whose impact extends well beyond liver cancer.
Using more than three decades of Global Burden of Disease data, researchers found that annual alcohol-attributable cancer deaths rose from 11,361 in 1990 to 23,126 in 2023. Men and adults age 55 and older experienced the greatest burden, but increases were seen across most cancer types, age groups and regions.
Alcohol has long been recognized as a Group 1 carcinogen by the International Agency for Research on Cancer, in the same category as tobacco smoke and asbestos. Scientific evidence links alcohol consumption to cancers of the breast, liver, esophagus, colorectum, and several head and neck sites.
“The most surprising finding was the breadth of alcohol’s potential impact across cancer types,” says Chinmay Jani, corresponding author of the study and chief fellow in hematology and oncology at Sylvester Comprehensive Cancer Center, part of University of Miami Miller School of Medicine.
“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.”
Among older men, liver cancer accounted for the highest alcohol-attributable mortality rates, followed by esophageal and colorectal cancers. Among women, breast cancer represented the leading source of alcohol-attributable cancer mortality.
The study also identified concerning patterns in younger adults. For men ages 20 to 54, colorectal cancer was the leading alcohol-attributable cause of cancer death. Among women in the same age group, breast cancer ranked first, followed by colorectal cancer.
“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 says.
The study also found substantial geographic variation. In 2023, Washington, DC, recorded the highest alcohol-attributable cancer mortality rates, while Utah had the lowest.
Although the study examined national trends, the findings have particular relevance for Florida, which has one of the nation’s largest populations of older adults, the age group that experienced the highest alcohol-attributable cancer mortality rates.
Gilberto Lopes, senior author and chief of the division of medical oncology at the Miller School, says the findings reinforce the importance of giving people clear information about lifestyle factors that influence cancer risk.
“What this study makes clear is that alcohol-related cancer risk is not limited to one disease or one group of people,” Lopes says.
“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.”
The findings may help inform education, prevention, and early detection efforts focused on modifiable lifestyle factors.
Despite increasing scientific evidence, public awareness of the alcohol-cancer connection remains relatively low compared with awareness of other risk factors such as tobacco use.
“The most important takeaway is greater awareness that alcohol may affect cancer risk beyond the liver,” Jani says.
“These findings highlight alcohol as a potentially modifiable risk factor, and while the lowest safe dose is not yet known, this study suggests that reducing consumption to the lowest amount feasible for each individual may help lessen its impact on cancer risk and overall health.”
Source: University of Miami
