Alcohol-attributable cancer deaths in the United States doubled between 1990 and 2023, rising from 11,361 to 23,126, in a new study that puts breast cancer at the center of the toll for women. Researchers said the increase was not confined to one cancer type, one age group or one region, but spread across most of the categories they examined.
The work was led by Chinmay Jani and colleagues at Sylvester Comprehensive Cancer Center, part of University of Miami Miller School of Medicine, and was first presented in 2025 at the American Society of Clinical Oncology Annual Meeting before being published in The Lancet Regional Health—Americas. Jani said the breadth of alcohol’s effect across cancer types was the most surprising finding, especially because the public tends to connect alcohol-related cancer risk mainly with liver disease.
That gap matters because the study ties alcohol to cancers well beyond the liver, including breast, colorectal, esophageal, pancreatic and prostate cancer. Alcohol is already classified as a Group 1 carcinogen by the International Agency for Research on Cancer, but the burden has often been understood in narrower terms than the data support. Among women, breast cancer was the leading source of alcohol-attributable cancer mortality. Among women ages 20 to 54, it ranked first. Among men ages 20 to 54, colorectal cancer was the leading cause of alcohol-attributable cancer death.
The findings were built from more than three decades of Global Burden of Disease data, which allows researchers to estimate how many cancer deaths can be linked to alcohol by applying population-level exposure patterns to cancer outcomes over time. In practical terms, that means the study was not counting every death in which alcohol appeared in a medical record. It was measuring the share of cancer deaths that can be attributed to alcohol based on the strength of the risk relationship and how widely alcohol is used across age and sex groups. That approach helps explain why the burden can rise even without a single dramatic policy change.
What stood out next was where the heaviest burden fell. Men and adults 55 and older experienced the greatest share of alcohol-attributable cancer deaths, and the pattern was not uniform across the country. Washington, D.C. recorded the highest mortality rates in 2023, while Utah had the lowest. Those differences are best read as a mix of exposure and population structure: places with more alcohol-related risk, more older adults, or both, will generally show a higher rate than places where the underlying risk profile is lower and the population is younger.
Gilberto Lopes said the study makes clear that alcohol-related cancer risk is not limited to one disease or one group of people. He added that clinicians have an opportunity to help patients understand alcohol as a modifiable risk factor and that even small, informed changes can be part of a broader cancer-prevention strategy. That message lands with particular force now because the study shows a long climb in deaths rather than a flat line, and because the cancers involved are not obscure: breast cancer alone remains a major source of alcohol-attributable mortality among women.
The unresolved question is not whether alcohol raises cancer risk. It does. The harder issue is why the burden kept rising for more than 30 years while public understanding stayed so narrow. The study answers the first part with numbers. It leaves the second to doctors, public health officials and the next round of prevention efforts.
