Attending a casual happy hour, giving a celebratory champagne toast, winding down at the end of the day with a glass of wine—these are all behaviors that may seem pretty innocuous, but can actually add up when it comes to alcohol-related cancer risk.
And that’s something more folks may want to pay close attention to: According to a new study aiming to highlight the carcinogenic properties of alcohol, alcohol-related cancer deaths have doubled since 1990.
Meet the experts: Gilberto Lopes, M.D., M.B.A., F.A.S.C.O., senior study author and the chief of medical oncology at the Sylvester Comprehensive Cancer Center at University of Miami Miller’s School of Medicine; and Chinmay Jani, M.D., corresponding study author and medical oncologist at the Sylvester Comprehensive Cancer Center.
“For decades, public messaging emphasized the dangers of drunk driving, addiction, and liver disease much more than alcohol-related cancer,” explains Gilberto Lopes, M.D., M.B.A., F.A.S.C.O., the study’s senior author and the chief of medical oncology at the Sylvester Comprehensive Cancer Center at University of Miami Miller’s School of Medicine. “Many people, therefore, know that alcohol can damage the liver, but have never been told clearly that alcohol itself is a carcinogen.”
While alcohol-related liver cancer deaths did experience the highest increase, the results show other organs are at risk, too. The study, which was published in The Lancet, also highlighted increased cases of colorectal, breast, esophageal, pancreatic, and other cancers attributable to alcohol.
So, what does that mean for you—and your happy hour habit? Below, study authors and oncologists share more about the findings and how you can protect yourself.
What the findings mean
Altogether, annual cases of alcohol-related cancers more than doubled from about 11,400 in 1990 to more than 23,100 in 2023. Older adults were responsible for a large portion of the mortality increase—people over 55 accounted for 19 in 100,000 alcohol-related cancer deaths compared to 2.4 in 100,000 among people ages 20 to 54.
The findings also suggest that although cancer deaths are trending down as a whole, alcohol-related cases are not seeing that same downtick. For instance, overall cancer mortality in women declined by about 29% during that 33-year period, but the drop in alcohol-attributed cancer deaths was much smaller—that decreased by only about 17%. In men, the findings were even more pronounced: Overall cancer mortality dropped by 34% from 1990 to 2023, but cancer deaths attributed to alcohol only decreased by 14%.
One thing to keep in mind: This study is not saying that cancer rates in general have doubled, or that your risk now is twice as high, says Chinmay Jani, M.D., corresponding study author and medical oncologist at the Sylvester Comprehensive Cancer Center. Other factors, like population growth and aging, likely account for part of the increase, he adds. And cancer also has a long latency period, he notes, meaning many of the deaths we see today may reflect drinking patterns and cumulative exposure over decades.
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The common thread among all of these findings is that many cases of cancer could have been prevented. “Overall, cancer mortality has fallen substantially because of improvements in prevention, screening, and treatment, but alcohol-attributable mortality has not declined to the same degree and has increased in some groups,” says Dr. Jani. “This means alcohol now accounts for a greater share of the remaining cancer burden.”
How alcohol affects organs other than the liver
Ethanol, the active ingredient within alcohol, is converted into acetaldehyde, a carcinogenic compound that can damage DNA, increase oxidative stress, and interfere with DNA repair, explains Dr. Lopes. It can also promote chronic inflammation and affect hormone pathways, two factors that can contribute to cancer development.
Dr. Lopes adds that different organs are affected by alcohol in different ways. For instance, tissues in the mouth, throat, and esophagus are directly exposed to alcohol and acetaldehyde. Alcohol can increase estrogen levels and influence estrogen-dependent pathways, which can fuel the development of breast cancer. Less is understood about the link between alcohol and pancreatic cancer, notes Dr. Lopes, which warrants more research.
How much alcohol is safe to drink?
“For cancer prevention, there is no amount of alcohol that we can call completely risk-free,” says Dr. Lopes. “In general, cancer risk increases with the amount consumed, but for some cancers, particularly breast cancer, increased risk has been observed even at relatively low levels of drinking.”
In other words, there is no magic cancer-preventing threshold, other than abstaining from alcohol. Realistically speaking, less is always better, notes Dr. Lopes. “For someone who drinks regularly, reducing the number of drinks and the frequency of drinking is a reasonable step,” he says. “This is not about prohibition or telling adults how to live. It is about informed choice: people deserve to know that cancer is one of the risks associated with alcohol consumption.”
The bottom line
“Most people know alcohol can damage the liver. Few realize that it can cause cancer,” says Dr. Lopes. “Changing that awareness is one of the simplest opportunities we have in cancer prevention.”
And importantly, it is never too late to cut back. “Someone in their 50s, 60s, or 70s should not think, ‘I’ve already been drinking for decades, so it no longer matters,’” Dr. Lopes adds. “What we do from today forward still matters.”
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