Alcohol-related cancer deaths rise steeply in the United States

New research shows that cancer deaths caused by alcohol have almost doubled in the United States since 1990, reaching more than 23,000 lives lost each year.

Investigators examined national mortality records for malignancies known to be fueled by alcohol, including tumors of the breast, liver, colon, mouth, throat, voice box, and esophagus. They charted how those figures changed between 1990 and 2021.

The researchers discovered that the overall number of deaths attributable to drinking rose from just under 12,000 to just over 23,000 during that span. The surge is especially pronounced among men older than 55, whose alcohol-related cancer mortality has risen a little more than one percent each year since 2007.

The analysis is led by the Sylvester Comprehensive Cancer Center at the University of Miami. It draws on three decades of data from the Global Burden of Disease database.

Public awareness still lags

Lead author Chinmay Jani, a hematology-oncology fellow at Sylvester, described the trend as “a big and concerning rise.” He noted that public understanding lags far behind the science.

Although the carcinogenic effects of alcohol have been clear to researchers for years, a 2019 survey by the American Institute for Cancer Research found that fewer than half of U.S. adults knew drinking raises cancer risk. In contrast, nearly nine of ten recognize the danger of smoking.

Jani hopes the new analysis, which earned an ASCO Merit Award, will prompt physicians as well as patients to take the link more seriously.

Men hit hardest by alcohol

Looking beyond national figures, the researchers broke down the data by gender and disease site. Alcohol-related cancer mortality among women has modestly declined since 1990, thanks to earlier detection and better treatments.

In men, however, the burden continues to inch upward, erasing any gains made through medical advances. Liver, colorectal, and esophageal cancers show the steepest increases in alcohol-linked deaths; colorectal and esophageal cancers also show the largest proportional increases relative to their total mortality.

The experts then asked how much of today’s cancer mortality can be caused by alcohol. Even for tumor types where overall death rates have fallen, the proportion attributable to drinking has climbed.

Across all cancers combined, alcohol now accounts for nearly fifty percent more deaths than it did thirty years ago. Other factors may lower fatalities, but alcohol is increasingly responsible for the remaining cancer deaths.

Geography and regional disparities

Geography adds another layer. State-level analysis shows wide variation: the District of Columbia and Texas top the chart for alcohol-related cancer mortality, while Utah, where religious norms curtail drinking, reports the lowest burden.

The investigators suggest that local drinking culture, socioeconomic status, and access to health care probably all influence these differences.

How alcohol causes cancer

At the biological level, alcohol promotes cancer through several pathways. Ethanol and its metabolite acetaldehyde can damage DNA and hamper genetic repair mechanisms; chronic drinking also alters hormone levels and fosters inflammation, especially in the liver.

People vary in how their bodies process alcohol, so genetic background may modulate individual risk.

Senior author Gilberto Lopes, medical director for Sylvester’s international programs, says a deeper understanding of these mechanisms could eventually allow doctors to identify patients who are unusually susceptible and tailor screening or preventive advice accordingly.

Limited alcohol warnings

Public-health experts note that alcohol’s contribution to mortality dwarfs more familiar hazards.

The surgeon general recently reported that drinking is implicated in roughly 100,000 new U.S. cancer diagnoses each year. It also contributes to about 20,000 deaths, numbers that far outstrip fatalities from drunk driving.

Yet government campaigns have historically focused on road safety while devoting far less effort to educating people about alcohol’s carcinogenic potential.

A new call for action

The scientists recommend a multipronged response. First, routine medical visits should include frank discussions of alcohol intake and its cancer risks, much as physicians already counsel patients about smoking.

Second, consumer awareness could be boosted through warning labels on alcoholic beverages and mass-media campaigns modeled on successful anti-tobacco efforts.

Third, evidence suggests that excise taxes, limits on retail hours, and restrictions on outlet density all lower community-level consumption and could help curb cancer deaths.

Finally, targeted outreach to older men in high-burden states could combine cancer screening with programs that support reduced drinking.

Cancer fight must include alcohol

While these policy levers are familiar, their application has been uneven. Many U.S. jurisdictions maintain low alcohol taxes; few require explicit cancer warnings at the point of sale.

Even in oncology clinics, conversations often revolve around chemotherapy side effects, genetic testing, and surgery rather than lifestyle factors.

Jani argues that the new data underline how behavioral choices can undermine medical progress. If the upward trend continues, alcohol will increasingly drive cancer mortality, offsetting gains from improved treatments as the population ages.

Lopes echoes that concern, emphasizing that alcohol consumption is a modifiable risk. The study’s message, he says, is straightforward: every drink carries more than social consequences; for tens of thousands of families each year, it is part of a chain that ends in a cancer ward.

Confronting that reality – through education, clinical practice, and public policy – will be essential if the nation hopes to keep pushing cancer deaths downward rather than letting alcohol erase hard-won victories in treatment and prevention.

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