Alcohol-Linked Cancer Deaths Doubled in US Over 33 Years: Why Even ‘Just One Drink’ Matters

Alcohol is increasingly being recognized as a cancer risk, and a new study has found that the number of alcohol-attributable cancer deaths in the United States doubled from 11,361 in 1990 to 23,126 in 2023. The study, published September 2, 2026, in The Lancet Regional Health – Americas, examined alcohol-related cancer mortality across the US by age, sex, cancer type and state.

The finding is important because it shows that alcohol is not only linked to developing cancer, but is contributing to a growing share of cancer deaths. The researchers found the burden was especially high among men and adults aged 55 and older, while some cancers showed concerning increases among younger adults as well.

The cancer death toll changed dramatically

Researchers from the University of Miami and other institutions analyzed data from the Global Burden of Disease 2023 database, covering the period from 1990 through 2023.

The analysis included 10 cancer groups, including liver, breast, colorectal, esophageal, stomach, pancreatic, prostate, laryngeal, oral, and pharyngeal cancers. The researchers used alcohol exposure estimates and established risk relationships to calculate how much cancer mortality could be attributed to alcohol.

Overall, alcohol-attributable cancer deaths rose from 11,361 in 1990 to 23,126 in 2023.

But the trend was not identical for everyone.

In 2023, men accounted for 17,477 alcohol-attributable cancer deaths, compared with 5,649 among women. Adults aged 55 and older accounted for 19,460 deaths, far more than the 20-to-54 age group.

Study first author Dr. Chinmay Jani told CNN that although overall cancer mortality has declined, the proportion of cancer deaths attributable to alcohol has increased substantially over the past 33 years.

Liver cancer was a major warning sign

The strongest increase was seen with liver cancer.

Among adults aged 55 and older, alcohol-attributable liver cancer mortality increased by about 109% among men and 105% among women between 1990 and 2023. In 2023, liver cancer had the highest alcohol-related mortality rate among older men.

Alcohol does not simply affect the liver directly. The body breaks down ethanol, the alcohol found in beer, wine, and spirits, into acetaldehyde, a toxic chemical that can damage DNA and interfere with the body’s ability to repair that damage. Alcohol can also contribute to inflammation and oxidative stress.

Johns Hopkins physician Dr. Panagis Galiatsatos explained that alcohol is different from smoking because its health risks can vary depending on factors such as genetics, drinking patterns, and a person’s existing health risks.

“As we go through this, you’ll understand that this isn’t as black and white as the cigarette,” Galiatsatos said.

Younger adults are not outside the risk

One of the more striking findings was that alcohol-related cancer mortality was not limited to older Americans.

Among people aged 20 to 54, colorectal cancer was the leading alcohol-attributable cause of cancer death among men in 2023. Breast cancer was the leading one among women, while colorectal cancer ranked second.

The researchers also found that alcohol-attributable cancer mortality increased in several cancer types among younger adults even when overall cancer mortality was moving in the opposite direction.

For example, among younger men, overall cancer mortality fell by 33.7% from 1990 to 2023, while alcohol-attributable cancer mortality increased by 14.2%.

That contrast is one reason the researchers say alcohol deserves greater attention as a preventable cancer risk.

What does “just one drink” really mean?

A major question for many people is whether having a drink every day is enough to matter.

The study does not mean that every person who has one drink will develop cancer. It is a population-level analysis that estimates deaths attributable to alcohol using exposure and risk data.

However, existing evidence shows that cancer risk can increase even at relatively low levels of alcohol consumption. Johns Hopkins notes that the risk rises as alcohol intake increases and says reducing consumption can lower risk.

A standard US drink is generally 12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor.

Galiatsatos said people who cannot completely eliminate alcohol can still benefit from reducing their intake.

“At the end of the day, if you’re not able to remove alcohol completely, can you keep it to the lowest level you can consume in a day? This would help lessen risk of cancer,” he said.

The World Health Organization has also stated that there is no level of alcohol consumption that is completely risk-free.

The risk is not the same everywhere

The study also found major geographic differences.

In 2023, Washington, DC had the highest alcohol-attributable cancer mortality rate, while Utah had the lowest for both men and women. Among men, Oklahoma, New Mexico and Tennessee recorded some of the largest increases over the study period.

The researchers say differences in drinking patterns, state policies, and socioeconomic conditions may contribute to these variations.

The study does not prove that alcohol was individually responsible for every cancer death counted. Instead, it uses population-level data and established risk relationships to estimate the portion of cancer mortality attributable to alcohol.

The larger message is that alcohol is a modifiable cancer risk factor. Cutting back cannot guarantee that someone will avoid cancer, but lowering exposure can reduce alcohol-related risk.

The study was published without external funding and used publicly available, de-identified Global Burden of Disease data.