Drinking Alcohol Increases Cancer Risk—But Very Few Americans Are Aware of the Link

Drinking alcohol of any kind—liquor, beer, and wine—is a leading risk factor for developing cancer, but too few Americans are aware of the risk, and it could be putting their health in jeopardy.

A research article published in Cancer Epidemiology, Biomarkers, and Prevention, a journal of the American Association for Cancer, shows that most Americans—more than 50%—report not knowing how alcoholic drinks affect cancer risk. Some individuals (10.3%) believed wine in particular decreased cancer risk.

“All types of alcoholic beverages, including wine, increase cancer risk,” senior study author William M.P. Klein, PhD, associate director of the National Cancer Institute’s Behavioral Research Program, said in a press release.

“This study’s findings underscore the need to develop interventions for educating the public about the cancer risks of alcohol use," said Klein, "particularly in the prevailing context of national dialogue about the purported heart health benefits of wine.”

Few Americans Know of Alcohol-Related Cancer Risk

To determine American's knowledge about the link between alcohol and cancer risk. researchers analyzed data from the 2020 Health Information National Trends Survey, which included survey responses from nearly 4,000 American adults.

The respondents were asked, "In your opinion, how much does drinking the following types of alcohol [wine, beer, and liquor] affect the risk of getting cancer?" Respondents were also asked about their awareness of the link between alcohol and heart disease, as well as their own current alcohol habits.

More than 50% of those surveyed reported not knowing how alcohol affects cancer risk. About 31% of U.S. adults were aware of the alcohol-cancer link for liquor specifically, followed by beer and wine (24.9% and 20.3%, respectively).

Incorrectly, 10% of U.S. adults surveyed believed wine decreases cancer risk, while fewer people—2.2% and 1.7%—believed beer and liquor decreases risk.

Age also determined if a person was more likely to know about alcohol's link to cancer risk. Adults over the age of 60 were less likely to be aware of alcohol as a risk factor for cancer, while adults ages 18–39 were more likely to know of the link. According to study authors, this may be due to longer-standing drinking habits among older Americans.

Drinking habits, however, were not associated with awareness of the link: non-drinkers, average drinkers, and heavy drinkers were similarly aware of alcohol's cancer risk.

Drinking Alcohol Is a Little-Known Carcinogen

“Alcohol is a leading modifiable risk factor for cancer in the United States and previous research has shown that most Americans don’t know this,” lead study author Andrew Seidenberg, PhD, MPH, who conducted this research while serving as a Cancer Prevention Fellow at the National Cancer Institute, said in a press release.

That previous research is a 2021 study published in Cancer Epidemiology, which estimated that the number of annual cancer diagnoses in the U.S. attributed to alcohol is around 75,000, including almost 19,000 cancer deaths.

Currently, alcohol is considered a risk factor in at least six different cancers: mouth, pharynx, and larynx cancers, along with esophageal, breast, colorectal, stomach, and liver cancers.

In its most recent Report on Carcinogens, the U.S. Department of Health and Human Services' National Toxicology program lists consumption of alcoholic beverages as as a known human carcinogen.

The main reason alcohol can cause cancer is because it produces a carcinogen called acetaldehyde when the body metabolizes it, according to  Edward Giovannucci, MD, a professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health in Boston, who was not involved with the new research. 

The human body naturally produces acetaldehyde in small amounts, but in large amounts, it can cause DNA damage, which is how carcinogens create abnormal cancer cells. 

Aside from acetaldehyde, drinking excessive amounts of alcohol can cause breakdown in the tissues it comes into direct contact with, such as the upper throat, esophagus and stomach, said Dr. Giovannucci.

The cancer risk for alcohol is lower than the risk carried by other, more well-known carcinogens. Smoking, for example, is responsible for about 20% of all cancers and about 30% of all cancer deaths in the U.S. However, "you don't want to ignore any carcinogens," Klein told Health.

Cutting Back on Alcohol Consumption

The Centers for Disease Control and Prevention (CDC) recommend that males drink no more than two alcoholic drinks daily, and females have no more than one. 

According to Klein, the more you drink in one sitting, the worse alcohol is for you, making binge drinking particularly dangerous. 

“When you are drinking a lot all at one time your body is trying to break it down and the more you drink, the more your acetaldehyde you create,” he said. 

If you’re concerned that you may be drinking too much, Klein said the most important thing you can do to cut back is not rely on willpower alone. “We know from years of research that simply relying on willpower is not effective because most of us will give in at one point or another,” he said. 

Instead, George F. Koob, PhD, director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), suggests beginning by taking a closer look at your relationship with alcohol: whether you tend to drink in certain settings or situations, if you do it out of boredom, or if you simply like the taste.

Once you've pinned down your why, find a substitute. For example, meditating to combat anxiety or reaching out to friends or family when you feel stressed instead of turning to drinking. Koob also recommends letting people close to you know about your goals to drink less: “It can be easier to make behavior changes if you know you’re supported by people close to you.”

If you’re a social drinker, Klein recommends substituting social outings that revolve around drinking for an activity that doesn’t have to include alcohol. It can seem hard, especially if others in your circle also rely on drinking as their main way to socialize, but it’s been done before. 

“People need social connection and having something like alcohol can be a way to facilitate that connection,” he said, adding that this is the relationship many people had with smoking before its health impacts became widely known. 

If you want professional help with reducing the amount you’re drinking, Klein recommends seeking out a therapist or certified health and wellness coach that specializes in behavior changes, substance use, and helping people establish and reach goals.