NATURAL HOLISTIC MEDICINE BLOG - Alcohol-attributable cancer deaths in the United States doubled between 1990 and 2023, climbing from 11,361 annual deaths to 23,126, according to a new study led by researchers at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine. The analysis, first delivered as an oral presentation at the 2025 American Society of Clinical Oncology Annual Meeting and subsequently published in The Lancet Regional Health—Americas, identifies alcohol as a potentially modifiable cancer risk factor whose harm reaches far beyond the liver.
Investigators drew on more than three decades of Global Burden of Disease data to map how drinking has shaped cancer mortality nationwide, finding that men and adults age 55 and older carried the heaviest burden even as increases appeared across most cancer types, age groups, and regions. At ASCO 2025, corresponding author Chinmay Jani, M.D., chief fellow in hematology and oncology at Sylvester, also received the Conquer Cancer Merit Award for the study and presentation.
Alcohol Ranked With Tobacco as a Group 1 Carcinogen
Alcohol has long been classified as a Group 1 carcinogen by the International Agency for Research on Cancer, placing it in the same evidence category as tobacco smoke and asbestos. Peer-reviewed science links consumption to cancers of the breast, liver, esophagus, colorectum, and several head and neck sites, yet that message has not fully reached the public.
“The most surprising finding was the breadth of alcohol’s potential impact across cancer types,” said Dr. Jani. “Although its relationship with liver cancer is widely recognized, its contribution to cancers such as colorectal, esophageal, breast, pancreatic and prostate cancer is less well understood by the public.”
The study’s national numbers—about 11,400 deaths in 1990 rising to more than 23,100 in 2023—underscore a quiet public-health shift that has unfolded over a generation. Researchers argue that because drinking is a lifestyle choice, a substantial share of these deaths could, in principle, be prevented through clearer information and lower consumption.
Which Cancers Drive Alcohol-Attributable Mortality
Among older men, liver cancer accounted for the highest alcohol-attributable mortality rates, followed by esophageal and colorectal cancers. Among women, breast cancer represented the leading source of alcohol-attributable cancer mortality, a pattern that challenges the common assumption that alcohol’s oncologic risk is confined to hepatic disease.
The team also documented concerning patterns in younger adults that invert the classic liver-first narrative. For men ages 20 to 54, colorectal cancer was the leading alcohol-attributable cause of cancer death, while among women in the same age group breast cancer ranked first and colorectal cancer second.
“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,” Dr. Jani said. Those findings arrive as clinicians nationwide report rising colorectal cancer diagnoses in people under 55, adding urgency to conversations about diet, screening, and alcohol use in early and mid-adulthood.
Taken together, the site-specific results show growing burdens from colorectal, breast, esophageal, pancreatic, and other cancers, not only hepatocellular carcinoma. The breadth of affected organs helps explain why the national death toll could double even as awareness campaigns have historically focused on the liver.
Geographic Variation From Washington, D.C., to Utah
The study found substantial geographic variation in 2023, with Washington, D.C., recording the highest alcohol-attributable cancer mortality rates and Utah the lowest. Those extremes likely reflect differences in drinking culture, religious and social norms, access to care, and the age structure of local populations, though the paper’s core contribution is the national trend rather than a full causal map of every state.
Although the research examined the country as a whole, the findings have particular relevance for Florida, which has one of the nation’s largest populations of older adults—the age group that experienced the highest alcohol-attributable cancer mortality rates. South Florida, where Sylvester serves one of the country’s most diverse patient populations, may use the data to shape education, prevention, and early-detection programs aimed at modifiable lifestyle factors.
What Physicians Say Patients Need to Hear
Gilberto Lopes, M.D., senior author and chief of the Division of Medical Oncology at the Miller School, said the results reinforce the duty to give people clear information about lifestyle factors that influence cancer risk. “What this study makes clear is that alcohol-related cancer risk is not limited to one disease or one group of people,” Dr. Lopes said.
“As physicians and cancer researchers, we have an opportunity to help patients understand that alcohol is a modifiable risk factor and that even small, informed changes can be part of a broader strategy to reduce cancer risk in our community,” he added. That framing treats cutting back as a practical clinical tool rather than a moral lecture, aligning prevention with the same shared decision-making used for screening and vaccination.
Despite mounting scientific evidence, public awareness of the alcohol-cancer connection remains relatively low compared with awareness of tobacco use. Many adults still associate drinking mainly with liver cirrhosis or injury, not with breast, colorectal, or esophageal tumors, which helps explain why the mortality curve has continued to rise.
No Known Lowest Safe Dose, Researchers Caution
“The most important takeaway is greater awareness that alcohol may affect cancer risk beyond the liver,” Dr. Jani said. “These findings highlight alcohol as a potentially modifiable risk factor, and while the lowest safe dose is not yet known, this study suggests that reducing consumption to the lowest amount feasible for each individual may help lessen its impact on cancer risk and overall health.”
That caution matters because some patients still hear mixed messages about “moderate” drinking and heart health, even as oncology evidence has tightened around a dose-response relationship for several solid tumors. Clinicians at Sylvester say the honest answer, for now, is that less is better and that zero remains the only intake with no added alcohol-related cancer risk.
How Sylvester Plans to Use the Findings
For Sylvester Comprehensive Cancer Center, the study aligns with ongoing work in cancer prevention, population-health research, and community engagement across South Florida and beyond. By mining large-scale Global Burden of Disease data, investigators hope to inform strategies that reduce preventable cancer deaths in a region with both a large older population and a highly diverse mix of patients.
Education campaigns, earlier colorectal and breast screening conversations, and candid counseling about drinks per week are among the practical next steps researchers and clinicians describe. The doubling of alcohol-attributable cancer deaths since 1990, they argue, is not an inevitable demographic fate but a signal that a Group 1 carcinogen hiding in plain sight still receives far less public attention than tobacco or asbestos.
Frequently Asked Questions (FAQ)
How much did U.S. alcohol-attributable cancer deaths increase from 1990 to 2023?
Annual alcohol-attributable cancer deaths in the United States rose from 11,361 in 1990 to 23,126 in 2023, roughly doubling over more than three decades according to Global Burden of Disease data analyzed by Sylvester Comprehensive Cancer Center.
Which cancers are linked to alcohol besides liver cancer?
Scientific evidence links alcohol to cancers of the breast, esophagus, colorectum, pancreas, prostate, and several head and neck sites. The International Agency for Research on Cancer classifies alcohol as a Group 1 carcinogen, the same category as tobacco smoke and asbestos.
Who faces the highest burden of alcohol-related cancer deaths?
Men and adults age 55 and older experienced the greatest burden. Among older men, liver cancer had the highest alcohol-attributable mortality, followed by esophageal and colorectal cancers; among women, breast cancer was the leading source.
Is colorectal cancer a leading alcohol-related killer in younger adults?
Yes. For men ages 20 to 54, colorectal cancer was the leading alcohol-attributable cause of cancer death. Among women in that age group, breast cancer ranked first and colorectal cancer second, surpassing liver cancer in both groups.
Is there a safe amount of alcohol for cancer risk?
The lowest safe dose is not yet known. Study corresponding author Dr. Chinmay Jani said reducing consumption to the lowest amount feasible for each person may help lessen alcohol’s impact on cancer risk and overall health.
Which U.S. areas had the highest and lowest rates in 2023?
In 2023, Washington, D.C., recorded the highest alcohol-attributable cancer mortality rates, while Utah had the lowest. Florida is also highly relevant because it has one of the nation’s largest older-adult populations.
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