Drinking just one standard alcoholic beverage a day may increase the risk of dying from several types of cancer, according to a new study examining more than three decades of health data in the United States.
The research, published in The Lancet Regional Health – Americas, found that alcohol’s contribution to cancer deaths increased substantially between 1990 and 2023.
During the period, the number of annual cancer deaths linked to alcohol more than doubled, rising from 11,361 to 23,126.
“While it’s true that overall cancer mortality has declined, we found the percentage of cancer deaths proportionally attributable to alcohol doubled in people 20 and older over the last 33 years,” said the study’s first author, Dr. Chinmay Jani.
Researchers found alcohol was associated with deaths from breast, prostate, colorectal, rectal, stomach, pancreatic and liver cancers, as well as cancers affecting the head and neck.
“Overall, we know alcohol is closely related to liver cancer mortality,” said Jani, chief clinical fellow in hematology and oncology at the Sylvester Comprehensive Cancer Center of the University of Miami.
“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,” he said. “In women, the leading cause was alcohol-related breast cancer.”
According to Jani, the increased risk was observed even among people consuming approximately one standard drink each day. In the US, that is equivalent to 12 ounces of regular beer, five ounces of wine or 1.5 ounces of 80-proof liquor.
For many years, US federal guidelines advised men to consume no more than two standard drinks daily and women no more than one.
However, the Trump administration removed those limits in January and instead advised Americans to “[consume less alcohol for better overall health].”
Cardiologist Dr. Andrew Freeman, who was not involved in the study, said the long-held perception that moderate daily drinking could be beneficial is increasingly being challenged by scientific evidence.
“What we used to think about alcohol continues to be eroded as modern science has shown us that there is no safe amount of alcohol consumption,” said Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver.
“This study in concert with several others suggests that the risks associated with consumption need much wider recognition.”
How alcohol may trigger cancer
The National Cancer Institute says alcohol can contribute to cancer development through several biological mechanisms. It can alter hormone levels, including estrogen, which is linked to breast cancer.
When alcohol is broken down in the body, it produces acetaldehyde, a substance classified by the NCI as a “probable human carcinogen.”
The compound can damage DNA and interfere with the body’s ability to repair such damage.
Alcohol can also increase oxidative stress, causing damage to DNA, proteins and cells while promoting inflammation. It may weaken cells in the mouth and throat, making them more vulnerable to carcinogens.
The effects can be even more significant when alcohol consumption is combined with cigarette smoking.
Alcohol can also interfere with the absorption and breakdown of nutrients such as vitamins A, C, D and E, as well as folates, which are believed to help reduce cancer risk.
Risk varies by age and sex
The researchers analysed more than 30 years of US data from the Global Burden of Disease Study, a large international research project tracking deaths, illnesses and disability associated with hundreds of risk factors.
Men and adults aged 55 and above recorded the greatest impact from alcohol-related cancer deaths. A
mong older men, the alcohol-attributable cancer mortality rate increased by nearly 24% over the 33-year period.
For men, liver cancer had the strongest association with alcohol, followed by oesophageal and colorectal cancers.
Among women aged 55 and older, breast cancer was the leading alcohol-related cause of death, followed by liver and colorectal cancers.
Jani said women and men under 55 could face a higher cancer risk from the same amount of alcohol compared with men over 55.
For the cancers examined in the study, prostate, pancreatic and stomach cancers recorded the smallest increases in alcohol-related deaths, although deaths from all three still rose over time.
Alcohol was also identified as a significant risk factor for cancers of the head and neck, including those affecting the lips, mouth, throat, voice box and oesophagus.
Up to one-fourth of head and neck cancers have alcohol as a risk factor, according to Jani, who said many of these cases could potentially be prevented.
“While our study does not have the data to show you should completely stop drinking alcohol, the message we want to deliver is that lowering your alcohol use to the lowest possible level will be best for your health.”
