Alcohol related cancer deaths in the United States have doubled over the past three decades. That is the central finding of a major new study published in The Lancet Regional Health Americas. Researchers found that annual deaths rose from 11,361 in 1990 to 23,126 in 2023. The trend touches far more than the liver.

The analysis was led by researchers at the Sylvester Comprehensive Cancer Center at the University of Miami. It drew on more than thirty years of Global Burden of Disease data. Researchers examined mortality rates for ten specific cancers. They stratified results by sex, age group and US state, building one of the most detailed pictures yet of how alcohol contributes to cancer deaths nationwide.

A Rising Toll Across Three Decades

The overall mortality rate for alcohol linked cancer deaths rose from 3.8 per 100,000 people in 1990 to 4.1 per 100,000 in 2023. That is a rise of 7.6 percent. Behind that modest overall shift sit much sharper divides. Rates climbed by 14.3 percent among men. They fell by 16 percent among women over the same period. Even so, the proportion of cancer mortality attributable to alcohol grew substantially for both sexes. It rose by 92 percent in men and 16.7 percent in women.

Chinmay Jani, corresponding author of the study and chief fellow in haematology and oncology at Sylvester, said the findings revealed just how wide the impact of alcohol on cancer had become. Its relationship with liver cancer is widely recognised, he noted. Its contribution to cancers such as colorectal, esophageal, breast, pancreatic and prostate cancer is far less well understood by the public.

Not Just a Liver Cancer Problem

Liver cancer remained the single largest contributor to alcohol related cancer deaths in 2023. It accounted for 7,686 deaths. Esophageal cancer followed with 4,902 deaths, then colorectal cancer with 3,818 deaths. Yet the proportion of deaths attributable to alcohol increased across almost every cancer type studied except liver cancer. The steepest rises came in stomach cancer, up 57.2 percent, pancreatic cancer, up 40.5 percent, and colorectal cancer, up 39.7 percent.

Among older men, liver cancer accounted for the highest alcohol attributable mortality rates. Esophageal and colorectal cancers followed close behind. Among women, breast cancer was the leading source of alcohol linked cancer deaths. This pattern fits earlier research showing that even low levels of alcohol intake can raise breast cancer risk. Alcohol elevates oestrogen concentrations in the body, a mechanism thought to drive much of that added risk.

Younger Adults Face a Different Pattern

Perhaps the most striking finding concerned adults aged between 20 and 54. In this age group, colorectal cancer was the leading cause of alcohol related cancer deaths among men. Breast cancer ranked first among women, with colorectal cancer close behind. Liver cancer showed the largest percentage rise within this younger cohort. Deaths climbed by 88.6 percent in men and 147.8 percent in women, even though liver cancer did not top the mortality tables for this group.

Jani said colorectal cancer was the leading cause of alcohol attributable cancer mortality in men aged 20 to 54. It was the second leading cause in women, he added, surpassing liver cancer in both groups.

Sharp Differences Between US States

The study also revealed wide geographic variation. In 2023, Washington DC recorded the highest alcohol attributable cancer mortality rates for both men and women. Utah consistently recorded the lowest. Oklahoma, New Mexico, West Virginia and Tennessee saw the sharpest rises in male mortality rates between 1990 and 2023. Each state saw increases of more than 55 percent. Researchers linked this to differences in local drinking cultures, state alcohol policy and broader social factors.

A Modifiable Risk Factor

Gilberto Lopes, senior author of the study and chief of the Division of Medical Oncology at Sylvester, said the findings underline why clear public information about lifestyle factors matters. Alcohol related cancer risk is not limited to one disease or one group of people, he said. Physicians and cancer researchers now have an opportunity to help patients understand that alcohol is a modifiable risk factor. Even small, informed changes can be part of a broader strategy to reduce cancer risk.

The researchers made a further calculation. If American adults followed the alcohol consumption limits previously set out in national dietary guidelines, an estimated 16,803 alcohol related cancer deaths could be prevented each year. That figure equals more than 83 percent of the alcohol attributable cancer deaths recorded in 2023. Alcohol is classified as a Group 1 carcinogen, placing it in the same category as tobacco smoke. The study adds to a growing body of evidence that cutting back on alcohol remains one of the clearest ways to lower long term cancer risk.

Source: dbrecoveryresources