Alcohol’s connection to cancer is often associated with the liver. But a new study suggests the toll is broader and growing.
Cancer deaths tied to alcohol consumption doubled in the United States between 1990 and 2023, rising from 11,361 to 23,126, according to an analysis led by researchers at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine.
The findings point to a risk that reaches beyond one disease or one age group. Men and adults 55 and older had the highest burden, but researchers also found increases across most cancer types, age groups and regions.
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Among adults ages 20 to 54, colorectal cancer was the leading alcohol-attributable cause of cancer death in men. Breast cancer ranked first among women in that age group.
“The most surprising finding was the breadth of alcohol’s potential impact across cancer types,” said Dr. Chinmay Jani, the study’s corresponding author and chief fellow in hematology and oncology at Sylvester. “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.”
The findings were presented at the 2025 American Society of Clinical Oncology Annual Meeting and published in The Lancet Regional Health – Americas. Researchers analyzed Global Burden of Disease data from 1990 to 2023, comparing alcohol-attributable cancer deaths by sex, age, cancer type and geography.
Alcohol is classified as a Group 1 carcinogen by the International Agency for Research on Cancer, a category that also includes tobacco smoke and asbestos. Scientific evidence has linked alcohol use to several cancers, including breast, liver, esophageal, colorectal and head and neck cancers.
In 2023, liver cancer accounted for the highest alcohol-attributable mortality rates among older men, followed by esophageal and colorectal cancers. Among women, breast cancer was the leading source of alcohol-attributable cancer mortality. The District of Columbia had the highest rates, while Utah had the lowest.
Dr. Gilberto Lopes, senior author and chief of the Division of Medical Oncology at Sylvester, said the study should help doctors talk more clearly with patients about alcohol as a cancer risk factor.
“What this study makes clear is that alcohol-related cancer risk is not limited to one disease or one group of people,” Lopes said. He said alcohol is a modifiable risk factor and that even small, informed changes can be part of broader cancer prevention efforts.
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