Cancer mortality associated with alcohol use has risen in the United States, disproportionately affecting males and adults aged at least 55 years, according to a population-based observational trend analysis published by Jani et al in The Lancet Regional Health – Americas.
“Our findings highlight the critical need for targeted prevention efforts and increased awareness to address the rising impact of alcohol consumption on cancer-related mortality,” the investigators commented.
Study Details
Using data from the Global Burden of Disease database, the investigators analyzed age-standardized mortality rates and the percentage of these rates attributable to heavy alcohol use, defined as consumption above the theoretical minimum risk exposure level, in the United States from 1990 through 2023.
The investigators assessed age-standardized mortality rates per 100,000 population for all cancers combined and 10 individual cancer types, stratifying the results by sex, age group (20–54 and ≥ 55 years), and location across the 50 states and the District of Columbia.
Alcohol-Attributable Cancer Mortality
Alcohol-attributable cancer deaths in the United States more than doubled over the past 3 decades, from 11,361 in 1990 to 23,126 in 2023. Mortality rates were higher among adults aged at least 55 years (19.2, 95% confidence interval [CI] = 12.8–28.7) vs those aged 20 to 54 years (2.4, 95% CI = 1.4–3.4) and among males (6.4, 95% CI = 3.8–9.7) vs females (2.1, 95% CI = 1.4–3.0).
Across most cancer types, age groups, and sexes, the percentage of mortality attributable to alcohol increased, most notably for liver cancer (113.9%).
In 2023, among adults aged at least 55 years, alcohol-related mortality rates were highest for liver cancer in males (12.7, 95% CI = 11.2–14.4) and breast cancer in females (2.4, 95% CI = 0.9–5.9). Among those aged 20 to 54 years, the highest rates were observed for colorectal cancer in males (0.9, 95% CI = 0.4–1.4) and breast cancer in females (0.9, 95% CI = 0.5–1.4).
By state, age-standardized mortality rates were highest in the District of Columbia (males: 9.8, 95% CI = 6.0–14.1; females: 3.5, 95% CI = 2.2–5.2) and lowest in Utah (males: 3.9, 95% CI = 2.4–5.9; females: 1.4, 95% CI = 0.9–2.0).
“The findings emphasize the need for sustained national efforts to reduce alcohol consumption as a risk factor for cancer mortality,” the investigators concluded. “Despite growing awareness of alcohol as a risk factor for cancer development, alcohol continues to contribute significantly to cancer mortality, with distinct sex-based patterns and cancer type–specific burdens.”
They continued, “Targeted public health interventions, strengthened alcohol policy measures, and ongoing surveillance are essential to mitigate the burden of alcohol-attributable cancer deaths. Further research is warranted to explore demographic and regional variations within the [United States], ensuring that interventions are both equitable and effective.”
Chinmay T. Jani, MD, of Sylvester Comprehensive Cancer Center, University of Miami, is the corresponding author of the article in The Lancet Regional Health – Americas.
Disclosure: For full disclosures of the study authors, visit thelancet.com.
