Alcohol consumption is one of the leading preventable causes of cancer, but many Americans don’t know it. That’s why U.S. Surgeon General Dr. Vivek Murthy is calling for updated warning labels on alcohol, just like those carried on cigarette packs.
His recommendation came on Friday (3) as part of a new report, which describes how the Alcohol consumption is the third leading preventable cause of cancer in the United States, after tobacco and obesity, increasing the risk of at least seven types of cancer.
“Alcohol is a well-established and preventable cause of cancer, responsible for about 100,000 cancer cases and 20,000 cancer deaths annually in the United States – more than the 13,500 alcohol-related traffic accident deaths per year in the U.S. – but most Americans are unaware of this risk.”
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The text is by Murthy, in a press release from the US Department of Health and Human Services. “This Advisory sets out steps we can all take to raise awareness of the cancer risk of alcohol and minimize harm.”
Breast cancer appears to have some of the clearest links, with 16.4% of total cases attributable to alcohol consumption. But the direct link between alcohol consumption and cancer risk is well established for at least six other types of cancer, including cancer of the colorectum, esophagus, liver, mouth (oral cavity), throat (pharynx) and voice box (larynx) – regardless of the type of alcohol consumed.
For some types of cancer, including breast, mouth and throat, evidence shows that the risk of developing cancer may increase with one or fewer drinks a day.
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This is alarming, Murthy’s report noted, considering how common alcohol use is among Americans: in 2019-2020, 72% of US adults reported having one or more drinks per week. But less than half of American adults know about the direct link between alcohol consumption and cancer risk – something first established in the late 1980s, with evidence building over time.
And while proponents of moderate drinking, from alcohol manufacturers to some scientists, believe that a little alcohol a day can reduce cardiovascular disease, more recent studies have criticized previous methodologies and challenge that view.
The American Medical Association, for example, applauded the recommendation, noting in a statement: “For years, the AMA has said that alcohol consumption at any level, not just heavy alcohol use or addictive alcohol use, is a factor modifiable risk for cancer. And yet, Despite decades of compelling evidence of this connection, many in the public remain unaware of the risk of alcohol. Today’s warning, along with an effort to update the Surgeon General’s health warning label on alcoholic beverages, will strengthen awareness, improve health and save lives.”
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The Argument for Updated Warnings
Currently in the U.S., all alcoholic beverages sold must have a label warning about the risks of birth defects as a result of consumption during pregnancy, as well as how drinking alcohol impairs your ability to drive a car and operate machinery and “may cause health problems.”
But the label has not been updated since its creation in 1988.
Other countries already have specific cancer warnings, including South Korea and, soon, Ireland, which, starting in 2026, will require a label that states: “There is a direct link between alcohol and fatal cancers“.
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According to Murthy’s statement, health warning labels are “well-established and effective approaches to increasing awareness of health risks and promoting behavior change,” with “considerable evidence” supporting their use.
In Canada, the release notes, a real-world experiment of placing colorful warning labels on alcoholic beverage containers noting that alcohol use can cause cancer brought a 10% increase in knowledge about the associations in just two months. (The experiment was stopped prematurely after backlash from alcohol industry lobby groups.)
The power to change the label declaration rests with the US Congress.
Alcohol is already a known carcinogen
More research is needed, notes Murthy, to determine how specific drinking patterns may affect cancer risk — as well as how drinking at specific ages and during certain developmental periods may influence cancer risk.
But the report also points out that the World Health Organization’s International Agency for Research on Cancer already classifies alcohol as a Group 1 carcinogen, the highest level – alongside tobacco, asbestos and formaldehyde.
Additionally, the World Cancer Research Fund/American Institute for Cancer Research places the evidence linking alcohol and cancer in its highest risk category. And the US National Toxicology Program concluded in 2000 that consumption of alcoholic beverages is known to be a human carcinogen – something agreed upon by the Centers for Disease Control and Prevention and the National Cancer Institute of the National Institutes of Health.
The way alcohol leads to cancer is by first breaking down in the body into acetaldehyde, a metabolite that causes cancer by binding to DNA and damaging it, causing a cell to grow uncontrollably and create a cancerous tumor.. Alcohol also generates “reactive oxygen species, which increase inflammation and can damage DNA, proteins, and lipids in the body through a process called oxidation,” the report continues.
Alcohol also alters hormone levels — including estrogen, which may play a role in breast cancer — and offers a way to dissolve carcinogens from other sources, such as tobacco smoke particles. This makes it easier for the particles to be absorbed by the body, increasing the risk of mouth and throat cancer.
Originally published in Fortune.com
