More than 23,000 Americans died from alcohol-linked cancer in 2023: Here’s what researchers found

More than 23,000 Americans died from cancers attributed to alcohol consumption in 2023, according to a new study that reveals a much broader health burden than the familiar warning about alcohol and liver disease.

Researchers from Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine examined more than three decades of Global Burden of Disease data and found that annual alcohol-attributable cancer deaths in the United States increased from 11,361 in 1990 to 23,126 in 2023. The findings were published Sept. 2 in The Lancet Regional Health – Americas.

The study’s significance goes beyond the headline number. Alcohol-linked cancer deaths were not confined to liver cancer or older Americans. Researchers found rising burdens involving colorectal, esophageal, breast, pancreatic and other cancers, with increases across most cancer types, age groups and regions.

The findings add to a growing body of evidence that treats alcohol as a significant and preventable cancer risk factor rather than a health concern limited to heavy drinking.

Alcohol-Linked Cancer Deaths Rose From 11,361 to 23,126

The researchers tracked alcohol-attributable cancer mortality in the US from 1990 through 2023.

Their analysis found annual deaths rose from 11,361 to 23,126, meaning the number more than doubled over the 33-year period.

The study used Global Burden of Disease data to examine the relationship between alcohol consumption and cancer mortality. It looked across different cancer types, age groups, sexes and geographic regions.

Men and adults aged 55 and older experienced the greatest overall burden, but the increase was not restricted to those groups. Researchers also found important alcohol-attributable cancer deaths among younger adults.

That distinction is important because public discussions about alcohol and cancer have often centred on long-term heavy drinking and liver disease.

The latest research paints a much wider picture.

The Cancer Risk Goes Far Beyond the Liver

Alcohol is strongly associated with several cancers, including cancers of the mouth, throat, voice box, esophagus, liver, colon and rectum, and breast. The Centers for Disease Control and Prevention also notes evidence linking alcohol with stomach, pancreatic and prostate cancers.

The new study found that this broader range of cancers is reflected in alcohol-attributable deaths.

Among men, liver cancer had the strongest association with alcohol in the study, followed by esophageal and colorectal cancers.

Among women aged 55 and older, breast cancer was the leading alcohol-attributable cancer killer, followed by liver and colorectal cancers.

Researchers also highlighted colorectal, esophageal and pancreatic cancers as part of the growing burden.

The findings challenge the idea that someone only needs to think about alcohol-related cancer when considering liver health.

Younger Adults Are Also Part of the Picture

One of the study’s notable findings was the impact among adults aged 20 to 54.

Researchers found that colorectal cancer was the leading alcohol-attributable cancer death among men in this age group, while breast cancer ranked first among women.

That finding matters as colorectal cancer rates among younger adults have become an increasing area of concern for researchers and public health officials.

It also means alcohol-related cancer risk cannot simply be viewed as something that emerges late in life.

The study found that older adults still carried the greatest overall burden, but younger people were not unaffected.

Why Can Alcohol Increase Cancer Risk?

Scientists have identified several biological mechanisms that help explain the connection.

When the body breaks down alcohol, it produces acetaldehyde, a chemical that can damage DNA. Alcohol can also contribute to oxidative stress and inflammation and affect hormone levels, including estrogen.

The National Cancer Institute says there is strong scientific evidence that alcohol causes cancer and notes that the International Agency for Research on Cancer classifies alcohol as a Group 1 carcinogen.

Alcohol can also make it easier for tissues in the mouth to absorb other carcinogens, which is particularly relevant when alcohol consumption occurs alongside tobacco use.

These mechanisms help explain why the cancer connection extends across multiple organs rather than being limited to the liver.

Can One Drink a Day Increase Cancer Risk?

This is one of the questions likely to draw the most attention from the study.

The answer is that even relatively low levels of alcohol consumption can increase the risk of some cancers.

The National Cancer Institute says epidemiological studies show that even light drinkers can have elevated risks for certain cancers. It specifically notes that women who consume one drink per day have a higher breast cancer risk than women who drink less than one drink per week.

The CDC also says some cancer risks increase with any amount of alcohol consumption, including breast cancer in women.

That does not mean one drink guarantees that someone will develop cancer. Cancer risk is influenced by multiple factors, including genetics, age, tobacco exposure, lifestyle and other environmental factors.

It does mean that “moderate” drinking should not automatically be interpreted as carrying no cancer risk.

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What Counts as One Standard Drink?

The amount of alcohol in a typical serving can be misleading because different beverages contain different concentrations of alcohol.

In the US, the CDC defines a standard drink as containing 14 grams, or 0.6 ounces, of pure alcohol. That is approximately equivalent to:

• 12 ounces of regular beer at 5% alcohol
• 5 ounces of wine at 12% alcohol
• 1.5 ounces of distilled spirits at 40% alcohol

A larger or stronger beverage can contain more than one standard drink even if it is consumed as a single serving.

That distinction matters when people estimate how much alcohol they consume.

Older Men Saw a Particularly Large Increase

The study found a particularly significant increase among men aged 55 and older.

Alcohol-attributable cancer mortality among this group increased by nearly 24% over the period examined, according to the reported findings.

Men also experienced a greater overall alcohol-attributable cancer burden than women.

The reasons are likely complex and can include differences in alcohol consumption patterns, cancer incidence, age distribution and other risk factors.

The researchers’ broader finding, however, is that alcohol-related cancer mortality is changing across the US population rather than following one single demographic pattern.

Alcohol Is Already Recognised as a Major Cancer Risk

The new findings are consistent with guidance from major public health organisations.

The National Cancer Institute says alcohol consumption accounted for about 5% of cancer cases and roughly 4% of cancer deaths in the United States based on 2019 estimates.

The CDC similarly states that drinking less alcohol lowers cancer risk and that all alcoholic beverages, including beer, wine and liquor, are linked to cancer risk.

That last point is important because the cancer risk is not unique to spirits.

Wine is not exempt, and switching from liquor to beer does not eliminate alcohol-related cancer risk. The relevant exposure is the alcohol itself.

What the Findings Mean for People Who Drink

The research does not mean that every person who drinks alcohol will develop cancer.

It does reinforce the idea that alcohol consumption is one potentially modifiable factor in cancer prevention.

The CDC says adults who choose to drink should understand that drinking less is associated with lower health risks, while people who do not drink should not start drinking for health reasons.

For people who already drink, reducing consumption can lower exposure to alcohol and potentially reduce associated health risks.

The message from researchers is less about predicting an individual’s outcome and more about recognising a population-level pattern: alcohol-attributable cancer deaths have risen substantially, and the impact extends across several cancer types.

 

Frequently Asked Questions About Alcohol and Cancer

How many Americans died from alcohol-related cancer in 2023?

The study estimated 23,126 alcohol-attributable cancer deaths in the United States in 2023, up from 11,361 in 1990.

Did alcohol-related cancer deaths really double in the US?

Yes. The study found that annual alcohol-attributable cancer deaths more than doubled between 1990 and 2023.

Which cancers are linked to alcohol?

Alcohol is linked to cancers of the mouth, throat, voice box, esophagus, liver, colon and rectum, and breast. Evidence also links alcohol with pancreatic, stomach and prostate cancers.

Is alcohol only linked to liver cancer?

No. The new research found substantial alcohol-attributable mortality involving breast, colorectal, esophageal, pancreatic and other cancers.

Can one drink a day increase cancer risk?

Yes. Research shows that even low levels of alcohol can increase the risk of some cancers. The NCI specifically notes elevated breast cancer risk among women who consume one drink daily compared with very infrequent drinkers.

What is a standard drink in the US?

A US standard drink contains 14 grams of pure alcohol. That is roughly 12 ounces of 5% beer, 5 ounces of 12% wine or 1.5 ounces of 40% distilled spirits.

Is wine safer than beer or liquor when it comes to cancer?

No type of alcoholic beverage is free from alcohol-related cancer risk. The CDC says beer, wine and liquor all increase cancer risk.

Who had the highest alcohol-related cancer burden in the new study?

Men and adults aged 55 and older experienced the greatest overall burden, though increases occurred across most cancer types, age groups and regions.

Can reducing alcohol lower cancer risk?

Reducing alcohol consumption can lower exposure to a known cancer risk factor. The CDC states that drinking less alcohol or not drinking at all can lower cancer risk.

Is alcohol officially classified as a carcinogen?

Yes. The International Agency for Research on Cancer classifies alcohol as a Group 1 carcinogen, meaning there is sufficient evidence that it causes cancer in humans.