Health

Cancer deaths linked to alcohol on the rise in the U.S.

The increase was seen mainly in men ages 55 and up.

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Yearly cancer deaths linked to alcohol have doubled in the United States over the last three decades, rising from just under 12,000 a year in 1990 to more than 23,000 a year in 2021, new research finds.

The increase was driven by deaths in men 55 and older, the study authors said.

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U.S. cancer deaths overall have fallen by about 35% over the same time period, according to data from the American Cancer Society.

The findings will be presented next week at the American Society of Clinical Oncology’s annual meeting in Chicago and have not yet been published in a peer-reviewed journal.

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“This is death as opposed to getting a disease. We can treat a lot of cancers, and we’re getting better at that, but this is really driving home the point that people are dying from cancer due to alcohol,” said Jane Figueiredo, a professor of medicine at the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center, who was not involved with the research.

The study focused on seven alcohol-related cancers: breast, liver, colorectal, throat, voice box, mouth and esophageal. Alcohol isn’t responsible for every case of these cancers, but it has been shown to be a driving factor in a percentage of them.

“When people think about alcohol, they don’t necessarily think of it as being a carcinogen like they do tobacco,” said Dr. Michael Siegel, a professor of public health and community medicine at the Tufts University School of Medicine, who was not involved with the study.

But it is. Once in the body, alcohol breaks down into acetaldehyde — a carcinogen also found in tobacco smoke. Alcohol damages DNA and makes it easier for the mouth and throat to absorb other carcinogens.

The International Agency on Cancer Research, a branch of the World Health Organization, classified alcohol as a carcinogen in 1987. Research at that time linked drinking to cancers of the head and neck (including the mouth, throat, voice box and esophagus) and liver cancers. It’s since been linked to breast and colorectal cancers.

A January report from the former U.S. surgeon general said alcoholic drinks should come with cancer warning labels. According to WHO, there’s no safe amount of alcohol consumption.

While research has shown a link between alcohol and cancer, "the majority of Americans are unaware of this risk," U.S. Surgeon General Vivek Murthy said.

The new research found that in 1991, 2.5% of all cancer deaths in men and 1.46% in women were related to alcohol. In 2021, those percentages rose to 4.2% and 1.85%, respectively.

Over that same time period, men saw a 56% increase in deaths from alcohol-related cancers specifically. For women, it was nearly 8%.

“It was not surprising that it was higher in men, but it was certainly surprising how much higher it was in men versus women,” said study co-leader Dr. Chinmay Jani, chief fellow of hematology and oncology at the University of Miami’s Sylvester Comprehensive Cancer Center. Historically, men have tended to start drinking alcohol earlier in life, Jani and his team noted.

However, sex-based drinking habits appear to be shifting. In recent years, an increasing number of women have become heavy drinkers, and slightly more young women binge drink than men, research has found.

Deaths from the seven alcohol-related cancers increased among men in 47 states, and in 16 states for women. In both groups, deaths among people living in New Mexico rose the most — nearly 60% for men and 18% for women. Oklahoma, for men, and Tennessee, for women, came in close second.

Washington D.C. and New York saw the biggest decreases for men, and Massachusetts and New York for women. Utah remained the state with the lowest alcohol-related cancer deaths.

Cancer deaths were highest among people 55 and older. In men in this age group, alcohol-related cancer deaths rose by more than 1% every year between 2007 and 2021.

“The carcinogenic effect probably isn’t affecting you right away in your younger age, but as you continue to drink as you age, this carcinogen has an accumulative effect on the body,” Jani said.

Of all seven alcohol-related cancers, liver, colorectal and esophageal cancers were the deadliest overall in 2021. In men specifically, liver cancer deaths were most common. For women, it was breast cancer.

“We know that even small amounts of alcohol can affect the breast tissue,” Figueiredo said.

Jani said the next phase of research should tease out how different racial and ethnic groups are affected by alcohol differently when it comes to cancer risk.

“The enzyme that metabolizes alcohol is lower in some ethnic groups than others, so acetaldehyde, the carcinogen in alcohol, is higher in these people,” Jani said.

Alcohol consumption in the U.S. hit its peak in the late 1970s and dropped until the late ’90s, data from the National Institute on Alcohol Abuse and Alcoholism show. Drinking also rose sharply during the pandemic, as did alcohol-related deaths.

Siegel said messaging around alcohol needs to shift from drinking responsibly to making sure people understand the health effects that even moderate drinking can pose.

“It’s not that we’re telling people they can’t drink. Every person has the autonomy to make their own decisions,” Siegel said. “But we want to make sure they are well-informed based on the facts rather than misconceptions.”

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