A new study led by experts at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, is the first to look at trends over time in alcohol-linked cancer mortality across the United States. The findings were presented at the 2025 ASCO Annual Meeting (Abstract 10519).
Earlier this year, the former U.S. Surgeon General issued an advisory warning to Americans about the strong links between alcohol consumption and an increased risk of several types of cancer. Although many of these links have long been known among scientists, the general public’s awareness of this connection is low.
To understand how alcohol may be fueling rates of cancer-related deaths, investigators delved into data from the Global Burden of Disease database. This public data set captures detailed disease information from around the world and estimates risk factors—including alcohol consumption—that likely contribute to diagnoses and deaths.
The researchers looked at total cancer deaths, as well as those due to specific cancer types known to be influenced by alcohol consumption: breast, liver, colorectal, pharyngeal, laryngeal, oral cavity, and esophageal cancers. They found that between 1990 and 2021, the total number of alcohol-related cancer deaths nearly doubled in the United States, rising from just under 12,000 deaths per year to just over 23,000. The burden is especially high in men over 55 years of age, who saw their alcohol-linked cancer mortality rise by just over 1% every year between 2007 and 2021.
A 2019 survey from the American Institute for Cancer Research found that while 89% of American adults know that tobacco raises the risk of cancer, only 45% know that alcohol does as well. According to the Surgeon General’s report, there are about 100,000 new cancer diagnoses related to alcohol every year in the United States, or around 5% of all cancer cases, and around 20,000 deaths are due to alcohol-linked cancer. That number exceeds significantly the annual number of deaths caused by drunk driving.
The increasing rate of alcohol-related cancer mortality seems to be entirely attributable to an increase in that rate among men. In women of any age, the rates have declined slightly since 1990. In men ages 20 to 54 years, the mortality rates increased slightly. However, the team also looked at proportions of cancer deaths due to alcohol and found that, even for cancers with declining mortality rates, the proportion due to alcohol for nearly all of them rose between 1990 and 2021 for both men and women. Among all cancers combined, the percentage of cancer deaths that are likely due to alcohol consumption increased by nearly 50% between 1990 and 2021.
Liver cancer, colorectal cancer, and esophageal cancer saw the largest increases in alcohol-related mortality, while colorectal and esophageal cancers saw the largest proportional increases. Trends varied at the state level, possibly because of different drinking cultures in different regions, as well as socioeconomic and health access differences.
Biology may also be a factor. Alcohol increases cancer risk through several different mechanisms, including DNA damage and altering levels of hormones. Biological differences among people may impact how alcohol consumption raises their individual risk, and a better understanding of these differences may enable physicians to screen for patients at highest risk and tailor counseling individually.
“We hope that our study will help educate the public on the impact of alcohol on individual cancer risk, as this is a potentially modifiable factor,” said senior study author Gilberto Lopes, MD, Chief, Division of Medical Oncology, and Associate Director for the Cancer Center and Medical Director for International Affairs at the Sylvester Comprehensive Cancer Center.
Disclosure: For full disclosures of the study authors, visit coi.asco.org.
