Alcohol-Linked Cancer Deaths Rising | MedPage Today

While overall cancer mortality rates have declined steadily over the last few decades, cancer deaths attributed to alcohol have been rising, a population-based observational trend analysis showed.

From 1990 to 2023, alcohol-attributable cancer deaths doubled from 11,361 (age-standardized mortality rate [ASMR] 3.8 per 100,000 population) to 23,126 (ASMR 4.1 per 100,000 population), reported Chinmay T. Jani, MD, of the Sylvester Comprehensive Cancer Center at the University of Miami, and colleagues.

The percentage of deaths attributable to alcohol increased across most cancer types, age groups, and sexes.

“The findings emphasize the need for sustained national efforts to reduce alcohol consumption as a risk factor for cancer mortality,” wrote Jani and colleagues in Lancet Regional Health-Americas.

“We saw that the cancer mortality rates were going down for some cancers, but that the percentage of mortality that is now because of alcohol was going up for all of these cancers, for both males and females, and for the younger and elderly population as well,” Jani told MedPage Today. “That is quite concerning.”

“An important message that we are trying to deliver is that this study does not say that you should completely stop drinking alcohol … but that it is a preventable cause of cancer mortality,” Jani said. “As individuals, people can identify if they have any other risk factors, like tobacco or family history, or any other diseases that could potentially lead to cancer. In those cases, they should identify themselves as a higher-risk individual and try to reduce alcohol intake as much as possible.”

In an accompanying commentary, Saul Beltrán-Ontiveros, PhD, of the Universidad Autónoma de Sinaloa in Mexico, and colleagues pointed out that alcohol consumption “remains deeply rooted in culture despite its well-documented carcinogenicity.”

In addition, public awareness of the association of alcohol with cancer remains low, with only 45% of American adults recognizing it as a risk factor compared with 89% who recognize tobacco as such, they noted.

“While the U.S. Surgeon General’s 2025 advisory recommending cancer risk warning labels on alcoholic beverages is a critical first step, it must be accompanied by comprehensive strategies including taxation, marketing restrictions, and healthcare-based screening and counseling,” they suggested.

For this study, Jani and team used data from the Global Burden of Disease (GBD) database to analyze ASMRs and the percentage of ASMRs attributable to heavy alcohol use, defined as consumption exceeding the theoretical minimum risk exposure level, in the U.S. from 1990 to 2023.

Looking across subgroups, they found that cancer mortality rates were higher among males than females in 2023 (ASMR 6.4 vs 2.1), with rates increasing 14.3% among males since 1990, but declining among females (-16%). However, the percentage of ASMRs attributable to alcohol increased substantially for both males and females (92% and 16.7%, respectively).

The ASMR was 2.4 in both 1990 and 2023 for adults ages 20 to 54, while these rates increased from 15.8 to 19.2 among adults ages 55 and older. Notably, the percentage of ASMRs attributable to alcohol increased in both groups over that time period — from 4.5 to 6.6 in the younger age group, and from 1.7 to 3.0 in the older age group.

“For the younger population, cancer mortality from colorectal cancer has taken over from liver cancer, especially among males, which is concerning,” Jani pointed out.

Specifically, colorectal cancer was the leading alcohol-attributable cause of death among younger males, and the third most common in males 55 and up after liver and esophageal cancers. Among females, colorectal cancer ranked second, surpassing liver cancer in the 20-54 age group, while remaining the third most common in those 55 and older after breast and liver cancers.

Overall, increases in the percentage of ASMRs attributable to alcohol were observed across all cancer types except liver cancer, with the highest seen in stomach (1.3-2.0, 57.2%), pancreatic (1.4-1.9, 40.5%), and colorectal (4.2-5.9, 39.7%) cancers.

At the state level, the District of Columbia recorded the highest ASMRs (males 9.8 and females 3.5), while Utah had the lowest (males 3.9 and females 1.4).

Jani and colleagues acknowledged that their study had limitations “inherent to the GBD framework and its observational design.” An important limitation was incompleteness of exposure data, including delays in data reporting in recent years, they noted.