Alcohol-Related Cancer Deaths in the US Have Doubled Since 1990, and Not Just Among Those With Liver Cancer

A haunting mystery about the rise in colon cancer cases among young people has been lingering around our news feeds for at least six years now. Medical researchers have struggled to nail down a what’s causing it—although they’ve offered plenty of potential suspects, like ultraprocessed foods, microplastics, and antibiotics, to name a few. But judging from a new study—built off decades of cases spanning 1990 to 2023 assembled for the Global Burden of Disease (GBD) 2023’s database—at least one of the culprits for this baffling spike in cases has been identified: alcohol. Researchers with the University of Miami’s Miller School of Medicine found that colorectal cancer was the most common cause of “alcohol-attributable” cancer deaths for men in the United States between the ages of 20 and 54. For U.S. women in that same age group, it was the second most common cause of alcohol-related cancer deaths, after breast cancer. Notably, these were only some of the many discoveries made by the researchers’ analysis. All told, they found that alcohol-attributable cancer deaths across all categories studied more than doubled over the past three decades—from an estimated 11,400 deaths in 1990 to over 23,100 in 2023, annually. “The most surprising finding was the breadth of alcohol’s potential impact across cancer types,” hematologist and oncologist Chinmay Jani, the study’s corresponding author, said in a statement. “Although [alcohol’s] 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,” Jani noted. A top shelf carcinogen Despite being categorized as a Group 1 carcinogen by the International Agency for Research on Cancer, alcohol has tended to duck public awareness of its cancer risks compared to more notorious Group 1 peers, like tobacco and asbestos. For this very reason, physician Vivek Murthy—the U.S. surgeon general under Presidents Obama, Trump, and Biden—made a push last year to have a warning labels placed on alcohol nationwide. (Congress has not demonstrated much interest in passing the law required to implement this idea.) Even a modest amount of alcohol appears to be linked to elevated cancer risks, Jani and his coauthors noted. Their study highlighted past research indicating that moderate drinking in the range of just 0.18 to 0.53 ounces (5 to 15 grams) of alcohol per day has been linked to heightened breast cancer risk in women—well within the government’s definition for one “standard drink.” Maps of the general age-standardized mortality rates (ASMRs) compared to the percentage of ASMR that the researchers linked to alcohol-related cancers—with darker reds indicating higher mortality. Credit: Jani, et al. / Lancet Regional Health Furthermore, Jani noted that the study’s specific findings on cancer deaths in younger people aged 20 to 54 seems to indicate a strong link between alcohol consumption and the rise in colorectal cancers cases seen in their data. And the finding certainly has company: Other recent studies this year have found that almost half of all new colorectal cancer cases are now diagnosed in adults under the age of 65. Millennials born around 1990 are now twice as likely to get this form of cancer, according to another study, than their Boomer relatives born around 1950. Another round “[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,” Jani said. Another round of testing will likely be needed to determine more clearly what that lowest safe dose might be, particularly given known limitations in the GBD dataset. As Jani and his coauthors acknowledged in their study, published this September in the journal The Lancet Regional Health—Americas, the database lacks patient details on race, ethnicity, and other factors that might link these cancer deaths to other overlapping cancer risks. The researchers indicated that cancer risks heightened by “socioeconomic and structural factors” were one category particularly obscured by the GBD dataset. But, for the study’s senior author, oncologist Gilberto Lopes, there’s also a democratizing virtue to having this large pool of data without those details. “What this study makes clear is that alcohol-related cancer risk is not limited to one disease or one group of people,” Lopes said in a statement.