In 2022, Congress requested a scientific review from the National Academies of Sciences, Engineering, and Medicine (NASEM) to study the associated risks of cancer and other health conditions and the use of alcohol. The concern was that the health risks associated with low-to-moderate consumption of alcohol may have been underestimated in previous reports.
At the same time, the U.S. Department of Health and Human Services (HHS) Interagency Coordinating Committee launched its own review on alcohol intake and health: the Scientific Findings of the Alcohol Intake and Health Study. The results from these two studies were meant to inform the next version of the Dietary Guidelines for Americans recommendation on alcohol consumption, which is expected this year.
Contradictory Conclusions
The new guidelines were to update the current alcohol intake recommendations calling for one standard drink daily for women and two for men.1 However, the two reports assessing the risk of alcohol use on health came to contradictory conclusions. The NASEM report found no association between moderate alcohol consumption and some cancers, including colorectal, oral cavity, pharyngeal, esophageal, or laryngeal. It did, however, find that compared with never drinking, consuming a moderate amount of alcohol was associated with a higher risk of breast cancer (moderate certainty).2 Based on data analyzed from eight studies from 2019 to 2023, the committee concluded that compared with never consuming alcohol, moderate alcohol consumption is associated with lower all-cause mortality (moderate certainty).2 Conversely, according to a draft version of the Alcohol Intake and Health Study, released in January 2025, the authors concluded that even this amount of moderate drinking could raise a person’s risk of injuries, liver disease, and cancer, with risks increasing the more a person drank.3
Given that alcohol intake is a potentially modifiable risk factor for cancer and cancer recurrence, it is imperative that we understand the cancer-specific outcomes of reducing alcohol consumption....— LAURA TENNER, MD, MPH, FASCO
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According to the study’s findings, alcohol use is associated with increased mortality for seven types of cancers, including colorectal, breast (female), liver, oral cavity, pharynx, larynx, and esophageal (squamous type). In addition, the report found that one standard drink per week increased the risk of premenopausal and postmenopausal breast cancer, although the risk was smaller than for other health conditions. The study also concluded that based on a meta-analysis of age-specific risks of an alcohol-attributable death, there was not a significant net benefit of alcohol consumption on all-cause mortality at any age.3
Despite the study’s conclusion, in September, the HHS pulled back the report and has informed the authors of the study that the report will not be submitted to Congress, as was previously planned.4 It has been reported that the authors now plan to submit their work for publication in a peer-reviewed medical journal.4
Establising a Link Between Drinking and Cancer Risk
Causal relationships between alcohol consumption and the development of several cancers (including cancers of the oral cavity, pharynx, larynx, esophagus, liver, colon, rectum, and in women, breast), as well as a suspected causal association for cancers of the pancreas and lung, have been established for decades. Studies have shown a linear correlation with both duration of alcohol use and amount of consumption.5
It is therefore especially concerning that the final results of the Alcohol Intake and Health Study, which are consistent with known historical data showing an association between alcohol use and cancer, will not be released publicly. It is also concerning that in the setting of two contradictory reports, the Alcohol Intake and Health Study was not considered for greater discussion.
Both reports commented on some possible health benefits of alcohol use, including a reduction in the risk of cardiovascular disease and ischemic stroke. However, these potential benefits are negated with any usage of more than two standard drinks per day and may be especially dangerous for patients with cancer and long-term cancer survivors.
It’s critically important that the evidence presented in both the NASEM report and the Alcohol Intake and Health Study be objectively evaluated by a bipartisan committee of scientists and medical physicians without financial ties to industry.— LAURA TENNER, MD, MPH, FASCO
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According to a study published in 2020, many cancer survivors self-reported as current alcohol drinkers (56.5%), with up to 21% engaging in binge drinking.6 Three years later, those numbers increased to 77.7% of cancer survivors who self-reported as current drinkers, with 23.8% engaging in binge drinking and 38.3% engaging in hazardous drinking.7 In addition to some evidence showing that regular alcohol use may increase the chances of cancer recurrence, regularly consuming a few drinks may also render cancer treatments less effective.8
Given that alcohol intake is a potentially modifiable risk factor for cancer and cancer recurrence, it is imperative that we understand the cancer-specific outcomes of reducing alcohol consumption. That includes critically examining all evidence-based data, including the Alcohol Intake and Health Study, on the risks/benefits of drinking alcohol.
Forming Health Guidelines Based on Rigorous Science
If the current Dietary Guidelines for Americans recommendations allowing for two standard drinks per day for men and one standard drink daily for women continue without modification based on new evidence from the Alcohol Intake and Health Study showing that even low amounts of alcohol consumption may increase the risk for certain cancers, large populations may be put at risk for an alcohol-associated new cancer or cancer recurrence.
Considering the growing number of cancer survivors in the United States, with a projected 21.6 million by 2030—up from more than 18 million today—and 26 million by 2040,9 adequate dietary and nutrition recommendations on alcohol consumption to reduce cancer recurrence as well as new primary cancers are urgently needed.
In 2017, ASCO published a statement on alcohol and cancer, which recognized drinking as an established risk factor for several malignancies and a potentially modifiable risk factor for cancer prevention.10 And, in 2023, the World Health Organization declared that “no level of alcohol consumption is safe for our health.”11
It’s critically important that the evidence presented in both the NASEM report, which has faced criticism for having panel members with financial ties to alcohol producers,3 and in the Alcohol Intake and Health Study be objectively evaluated by a bipartisan committee of scientists and medical physicians without financial ties to industry. The committee’s assessment could then be used to guide the next edition of the Dietary Guidelines for Americans. Government recommendations about our health should be formed only by the best evidence-based science.
DISCLOSURE: Dr. Tenner reported no conflicts of interest.
REFERENCES
- Dietary Guidelines for Americans: Guidance on alcoholic beverages in the Dietary Guidelines for Americans. Available at www.dietaryguidelines.gov/alcohol/info. Accessed October 10, 2025.
- Calonge BN, Stone KB: Review of evidence on alcohol and health: Consensus study report. National Academies of Sciences, Engineering, and Medicine. Available at https://nap.nationalacademies.org/read/28582/chapter/1. Accessed October 10, 2025.
- Shield K, Keyes KM, Martinez P, et al: Draft Report: Scientific findings of the Alcohol Intake & Health Study for public comment. January 2025. Available at https://www.samhsa.gov/sites/default/files/2025-draft-public-comment-alcohol-intake-health-study.pdf. Accessed October 10, 2025.
- Rabin RC: Federal report on drinking is withdrawn. The New York Times, September 5, 2025. Available at www.nytimes.com/2025/09/05/health/alcohol-drinking-hhs-report.html. Accessed October 10, 2025.
- Boffetta P, Hashibe, M: Alcohol and cancer. Lancet Oncol 7:149-156, 2006.
- Sanford NN, Sher DJ, Xu X, et al: Alcohol use among patients with cancer and survivors in the United States, 2000–2017. J Natl Compr Canc Netw 18:69-79, 2020.
- Shi M, Luo C, Oduyale OK, et al: Alcohol consumption among adults with a cancer diagnosis in the All of Us Research Program. JAMA Netw Open 6:e2328328, 2023.
- Philips C: Drinking alcohol, often heavily, common among people with cancer and long-term survivors. National Cancer Institute, September 15, 2023. Available at www.cancer.gov/news-events/cancer-currents-blog/2023/cancer-survivors-alcohol-drinking-common. Accessed October 10, 2025.
- National Cancer Institute: Dedicated to enhancing the length and quality of life of cancer survivors. Available at https://cancercontrol.cancer.gov/sites/default/files/2022-08/NCI_DCCPS_OCS_Fact_Sheet.pdf. Accessed October 10, 2025.
- LoConte NK, Brewster AM, Kaur JS, et al: Alcohol and cancer: A statement of the American Society of Clinical Oncology. J Clin Oncol 36:83-93, 2018.
- World Health Organization: No level of alcohol consumption is safe for our health. January 4, 2023. Available at www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health. Accessed October 10, 2025.
Dr. Tenner is Associate Professor of Medicine in the Division of Oncology and Hematology at the University of Nebraska Medical Center. She has served as a member of ASCO’s Board of Ethics Cancer Prevention Committee and Government Relations Committee and currently serves on ASCO’s Health Policy Committee and ASCO’s Certified Steering Group.
