Sobering Thoughts: Alcohol and Cancer

Surgeon General Advisory

On January 3, 2025 the US Surgeon General issued a new advisory outlining the direct link between alcohol consumption and increased cancer risk. There are approximately 20,000 alcohol-related cancer deaths in the United States each year.¹

While this advisory is new, the evidence showing that alcohol causes cancer has been growing for decades, especially with respect to cancers of the:

• Breast
• Oral/mouth
• Throat
• Esophagus
• Colon
• Liver

Breast cancer as an example

• We have had rigorous, compelling evidence that alcohol causes breast cancer dating back to at least 1987²
• The risk of breast cancer increases by 7-10% for every 10 grams of alcohol consumed each day.³ 10 grams of alcohol is less than 1 drink, with a standard drink being 14 grams (see below)
• Women who have 2-3 standard drinks per day have a 20% greater risk of developing breast cancer compared to those who abstain⁴
• The risk for developing breast cancer is dose-dependent. The more alcohol consumed, the higher the risk

Awareness of the link between alcohol and cancer is low

For instance, in a 2020 survey of college-aged women, only 3% were aware of the link between alcohol and breast cancer.³ In another study done in 2021, only 33% of adults believed alcohol is a cancer risk factor.⁵

Why is awareness so low if we’ve known about the link between alcohol and cancer for so long?

The answer is complicated. Contrary to smoking, we get mixed messages about alcohol use and health. A common belief is that moderate drinking is actually good for us, especially red wine and heart health. This misconception is related to studies done in the 1970s and 1980s that have since been amended if not disproven. The USDA offers guidelines for alcohol use – whereas there are no guidelines for tobacco use – which can imply that alcohol consumption within those guidelines is harmless. However, the data show that alcohol consumption even within these guidelines confers an increased risk of cancer. Finally, much like the tobacco industry, the alcohol industry is large and powerful.

This is why the Surgeon General’s warning is so important: to increase awareness to empower people to make decisions about alcohol and their health.

The Good News!

There is so much about cancer risk we cannot control, such as genetic predisposition, a multitude of environmental exposures, and more. Fortunately, alcohol consumption is a modifiable risk factor for cancer. We have the power to lower our risk!

Take-away points:

• There is no safe amount of alcohol consumption with respect to cancer risk
• Cancer risk exists even within the current USDA guidelines of alcohol consumption (i.e., no more than 1 standard drink/day for women, no more than 2 standard drinks/day for men <65 years old, no more than 1 standard drink/day for all persons 65 and older)
• The less alcohol consumed, the lower the risk

Presented to Empower You to Make Decisions About Your Health

For more information:

Visit the American Cancer Society's web page. 

 

Dr. Megan McCarren, MD, FASAM is a Board-certified internist and addiction medicine specialist at Saint Alphonsus, Boise.

1. https://www.hhs.gov/about/news/2025/01/03/us-surgeon-general-issues-new…
2. Willett WC, Stampfer MJ, Colditz GA, et al. Moderate alcohol consumption and the risk of breast cancer. New Engl J Med. 1987;316(19):1174–1180. doi: 10.1056/nejm198705073161902
3. Freudenheim, J. Alcohol’s effects on breast cancer in women. Alcohol Res. 2020, Jun 18; 40(2):11. doi: 10.35946/arcr.v40.2.11
4. https://www.komen.org/breast-cancer/risk-factor/alcohol-consumption/
5. Kiviniemi, MT et al. Limitations in American adults’ awareness of and beliefs about alcohol as a risk factor for cancer. Preventive Medicine Reports Sept 2021 (23); https://doi.org/10.1016/j.pmedr.2021.101433