Alcohol’s Cancer Risk Extends Far Beyond the Liver, Study Finds

Alcohol-attributable cancer deaths in the U.S. doubled between 1990 and 2023, a new study found, with these deaths not limited to older adults or liver cancer. Among adults ages 20 to 54, colorectal cancer was the leading alcohol-attributable cancer death in men, while breast cancer ranked first in women, with a growing burden also seen from esophageal, pancreatic, and other cancers.

Led by researchers at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, the findings were first presented at the 2025 American Society of Clinical Oncology Annual Meeting and are now published in The Lancet Regional Health – Americas. Using more than three decades of Global Burden of Disease data, researchers found annual alcohol-attributable cancer deaths rose from 11,361 in 1990 to 23,126 in 2023, with men and adults 55 and older experiencing the greatest burden but increases seen across most cancer types, age groups and regions.

Alcohol has long been recognized as a Group 1 carcinogen by the International Agency for Research on Cancer, alongside tobacco smoke and asbestos, with evidence linking alcohol to cancers of the breast, liver, esophagus, colorectum and several head and neck sites.

“The most surprising finding was the breadth of alcohol’s potential impact across cancer types,” said Chinmay Jani, corresponding author of the study. “Although its 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.”

Among older men, liver cancer accounted for the highest alcohol-attributable mortality rates, followed by esophageal and colorectal cancers, while breast cancer led among women. In younger adults, the pattern shifted: for men ages 20 to 54, colorectal cancer was the leading alcohol-attributable cause of cancer death, and among women in the same age group, breast cancer ranked first, followed by colorectal cancer. “Notably, among adults aged 20 to 54, colorectal cancer was the leading cause of alcohol-attributable cancer mortality in men and the second leading cause in women, surpassing liver cancer in both groups,” Jani said.

The study also found substantial geographic variation: in 2023, Washington, D.C., recorded the highest alcohol-attributable cancer mortality rates, while Utah had the lowest. The findings have particular relevance for Florida, which has one of the nation’s largest populations of older adults, the age group with the highest alcohol-attributable cancer mortality rates.

Senior author Gilberto Lopes said the findings reinforce the importance of giving people clear information about lifestyle factors influencing cancer risk. “What this study makes clear is that alcohol-related cancer risk is not limited to one disease or one group of people,” Lopes said. “As physicians and cancer researchers, we have an opportunity to help patients understand that alcohol is a modifiable risk factor and that even small, informed changes can be part of a broader strategy to reduce cancer risk in our community.”