Alcohol and Cancer

Farmin Shahabuddin, MPH, Ealena Callender, MD, MPH, & Meg Seymour, PhD, Cancer Prevention and Treatment Fund

The link between alcohol and cancer may surprise you. The American Society of Clinical Oncology reports that drinking alcohol increases the risk of cancer of the mouth and throat, vocal cords, esophagus, liver, breast, and colon. In fact, a 2024 report from the American Association for Cancer Research identified alcohol as a potential explanation for statistics indicating an increase in breast cancer and colorectal cancer among younger adults (Click here to see the AACR Report).1 The risks are greatest in those with heavy and long-term alcohol use. Even so, moderate drinking can add up over a lifetime, which could be harmful.2

What is Moderate Drinking? Heavy Drinking?

The 2020-2025 Dietary Guidelines for Americans recommends that Americans reduce their risk of alcohol-related health problems by drinking in moderation, which means 1 drink per day or less for women and 2 drinks per day or less for men.3 However, not all “drinks” are equal. A drink is defined as approximately 0.6 fluid ounces of alcohol, which equals: 1.5 ounces of distilled spirits (e.g., vodka, gin, tequila, etc), 5 ounces of wine, 12 ounces of beer, and 8 ounces of malt liquor.4 (Click here to see the CDC’s fact sheet.) The guidelines define moderate drinking as two drinks or less per day for men and one drink or less per day for women.

The CDC describes heavy drinking as having more than eight drinks per week for women and more than 15 drinks per week for men. Binge drinking refers to consuming multiple drinks on a single occasion – four or more drinks for women and five or more drinks for men.

Drinking and Cancer

In January 2023, the Canadian Centre on Substance Use and Addiction (CCSA) published updated guidelines that recommend limiting alcohol use to two or fewer drinks per week to reduce the risk of harm from alcohol.5 At that level, they say the risk of harm from alcohol is low. Risk is moderate for those who drink three to six servings of alcohol per week and “increasingly high” for those who drink seven or more. The report warns that drinking three to six alcoholic beverages per week is associated with increased risk of several types of cancer.

These guidelines may surprise many people, especially those who assumed moderate drinking was not anything to be concerned about.  But research indicating the risk of cancer from drinking even small amounts of alcohol has been published for years.  For example, Alcohol is known to cause at least six types of cancer: mouth and throat cancer, larynx (voice box) cancer, esophageal cancer, colon and rectal cancer, liver cancer, and breast cancer in women.6 A 2021 study found that 4% of all new cancer cases diagnosed throughout the world in 2020 were attributable to alcohol consumption, and the researchers say that may be a low estimate.7

Depending on the amount a person drinks, they can increase their chances of developing even rare cancers. For example, moderate drinkers can almost double their lifetime risk of mouth and throat cancer to almost 2%, while heavy drinkers increase their risk of having mouth or throat cancer from 1% to 5%.2 A 2020 study from Australia found that the heaviest drinkers (drinking more than 14 drinks per week) had an overall higher likelihood of developing cancer, compared with those who drank the least (1 or 0 drinks per week). The men who drank the most had a 4.4% higher overall likelihood of developing cancer than the men who drank the least, and the women who drank the most had a 5.4% higher overall chance of developing cancer.8

Women need to be more cautious about drinking any amount of alcohol because alcohol is even more likely to cause cancer in women than in men. Research has shown that women who drink even 1 drink per day have a 5-9% higher chance of developing breast cancer, compared with women who do not drink.9 The risk is even higher for women who drink more. One reason may be that alcohol affects the amounts of certain sex hormones circulating in the body. For women who have had hormone receptor-positive breast cancer, seven or more weekly drinks increased the chances of having a new cancer diagnosed in the other breast from about 5% to about 10%.2

Heavy drinking is also risky for those who currently have or have had other types of cancer. Among all cancer survivors, heavy drinking caused an 8% increased risk of dying and a 17% increased risk of cancer recurrence. Patients with cancer who abuse alcohol do worse because alcohol causes poorer nutrition, a suppressed immune system, and a weaker heart.2

In 2020, an estimated 100,000 cases of cancer globally were caused by light to moderate drinking (fewer than two alcoholic beverages per day).7 A study of alcohol use in the European Union found that a drinking level of less than one drink per day was linked to 40% of alcohol-related cancers in women and 32% in men.10

Individuals who increase their alcohol use may also increase their chance of getting cancer, according to a large 2022 study.11 Compared with men and women who maintained the same level of drinking over about six years, the study found that those who increased their alcohol consumption were more likely to get cancer. While those who increased their alcohol consumption most dramatically saw a more significant increase in their risk of cancer, even those who only increased their consumption by a small amount had a higher risk of cancer than those who did not change their level of drinking.

What New Research Shows About Alcohol and Overall Health

Recent research adds important new evidence about how alcohol affects overall health and survival. A study published in JAMA Network Open in 2023 analyzed results from 107 previous studies, including more than 4.8 million people around the world. 12 Earlier reports had suggested that light or moderate drinking might help people live longer by reducing heart disease risk. However, this new analysis corrected for key problems in older research—such as counting former drinkers who quit for health reasons as “nondrinkers.” Once those biases were removed, the supposed benefits disappeared.

Researchers found that people who drank small amounts of alcohol (less than about two drinks per day) did not live longer than people who never drank. Starting at around two drinks per day, the risk of dying early began to climb, and it continued to rise the more someone drank. The increase in risk was stronger for women than for men at the same drinking levels. Overall, the researchers concluded that there is no safe level of alcohol for longevity or health. Even small amounts do not protect against death from heart disease or any other cause.

Another study published in JAMA Network Open in 2023 looked at how alcohol-related deaths have changed in the United States from 1999 to 2020. 13 Using national CDC data, they found that over 605,000 alcohol-related deaths occurred in those 21 years. Men still die more often from alcohol-related causes, but the gap between men and women is narrowing. From 2018 to 2020, alcohol-related deaths increased by about 14–15% per year among women and 12–13% per year among men. Deaths included not only liver disease and alcohol poisoning but also heart problems, pancreatitis, and other long-term health effects.

The researchers believe this rise may reflect increased stress, heavier drinking patterns, and reduced access to treatment during the COVID-19 pandemic, especially for women. The findings highlight that alcohol harms are not limited to addiction or accidents; they extend to multiple organs and contribute to premature death. Together, these two studies show that alcohol offers no health benefits, only risks. Drinking less or not at all is the safest option for reducing your chances of cancer, liver disease, heart disease, and early death.

In 2025, the U.S. Surgeon General issued an advisory warning about the link between alcohol and cancer and called for adding cancer warning labels to alcoholic beverages and for health professionals to discuss alcohol use with patients routinely. 14 In 2020, an estimated 74,000 cancer cases globally were related to alcohol consumption. In the U.S., it is reported that alcohol is now the third-leading preventable cause of cancer in the U.S. after smoking and excess weight, and is responsible for 5.4% of all cancer cases and 4.1 of cancer deaths in adults aged 30 and older.

A 2015 meta-analysis of 572 case-control and cohort studies summarized the scientific evidence behind the advisory. The review explained that alcohol increases risk by producing acetaldehyde, a toxic chemical that damages DNA; raising estrogen levels, which promotes breast cancer; and acting as a solvent for other carcinogens like tobacco smoke. The analysis found that heavy drinkers (drinking more than 3.5 drinks per day) in comparison to non-drinkers and occasional drinkers, increased the risk of raises the risk of the mouth and pharynx, larynx, esophagus, female breast, colorectum, and liver. 14

The 2018 World Cancer Research Fund (WCRF) Third Expert Report also found strong evidence supporting an increased risk of colorectal cancer associated with consuming equal to or greater than 2 drinks per day and liver cancer associated with consuming greater than or equal to 3 drinks per day. The Surgeon General emphasized that reducing alcohol intake can lower cancer risk and urged that clinicians should include alcohol screening and brief counseling in routine care. 14

How Alcohol Causes Cancer

Scientists believe that alcohol causes cancer in several ways: 15

  • Alcohol (ethanol) is broken down into a toxic substance called acetaldehyde, which is directly toxic to the body’s cells.
  • Alcohol causes damage to cells through a process called free-radical oxidation.
  • Alcohol causes the body to absorb less folate (an important B vitamin) and other nutrients (antioxidant vitamins A, C, and E), which naturally repair damage and fight off cancers.
  • Alcohol increases the body’s level of estrogen (a sex hormone associated with breast cancer)

Isn’t Moderate Drinking Good for My Heart?

You may have heard that moderate drinking is good for your heart, but new research shows that’s not true for most people, especially older adults or those with health or financial challenges. A large 2024 study followed more than 135,000 adults aged 60 and older in the United Kingdom over 12 years to examine how different drinking patterns affected their risk of death.¹5 Participants were grouped into occasional drinkers, low-risk drinkers (up to about one drink per day for women and two for men), moderate-risk drinkers (roughly one to two drinks a day for women and two to four for men), and high-risk drinkers.

The researchers found that compared with occasional drinkers, people who drank even modest amounts of alcohol had a higher risk of dying from all causes, including cancer and heart disease. High-risk drinkers were 33% more likely to die overall, 39% more likely to die from cancer, and 21% more likely to die from cardiovascular disease.

Even moderate-risk drinkers had a 10% higher overall death rate and a 15% higher cancer death rate, and those in the so-called low-risk group still had a higher cancer mortality than occasional drinkers. The risks were even greater among older adults with existing health problems (like frailty, diabetes, or high blood pressure) or those with lower socioeconomic status, such as lower income or limited access to healthcare. For these groups, even small amounts of alcohol raised their chances of dying early.

The study also found a small exception: people who mostly drank wine with meals had slightly lower risks of death, but only among those who did not have any health or financial challenges. The researchers believe this may be because these individuals tended to have healthier lifestyles overall, ate more balanced diets, or absorbed alcohol more slowly with food, not because wine itself is protective.

In simple terms, this study shows that even so-called “moderate” drinking is not heart-healthy or risk-free, particularly for older adults or those with chronic health issues. The safest approach remains the same—drink less, or not at all.

Low Public Awareness

Despite decades of research, most Americans still don’t realize that alcohol can cause cancer. A 2025 study from the University of Texas MD Anderson Cancer Center, published in JAMA Oncology, analyzed data from the 2024 Health Information National Trends Survey. 16 Out of 6,793 U.S. adults surveyed, only 37% knew that drinking alcohol increases cancer risk, about 9% believed alcohol had no effect, or even reduced risk, and more than half (53%) said they didn’t know.

People who had drunk alcohol in the past month were more likely to believe it had no effect, showing a disconnect between behavior and awareness. Lack of knowledge was more common among those with less education, current smokers, and people who believed cancer is not preventable. The authors stressed that improving public awareness through education campaigns and warning labels could help reduce alcohol-related cancers nationwide.

What You Can Do to Lower Cancer Risk for You and Your Family

  • If you drink alcohol, limit drinks to an average of 1 a day for women and 2 a day for men.
  • Recognize heavy drinking in a loved one, because the more a person drinks, the greater his or her chances of developing cancer. The “CAGE” questionnaire provided here can help spot heavy drinking.
    1. Has the person tried to cut back?
    2. Has the person been annoyed when asked about drinking?
    3. Has the person felt bad or Guilty?
    4. Has the person needed a drink first thing in the morning (Eye opener)? Each “yes” counts as 1 point. A score of 2 or more suggests problem drinking.
  • Talk with your doctor about your risk. Doctors can refer or offer counseling and treatment services to patients with risky drinking habits.
  • Seek help early. Problem drinking can’t be wished away. There are many resources to access information and help. The Substance Abuse and Mental Health Services Administration (SAMHSA), which is part of the U.S. Department of Health and Human Services (HHS), has a toll-free hotline and website. Call 1-800-662-HELP (4357) or visit https://findtreatment.samhsa.gov/
  • Practice healthy habits. Eating a diet rich in cancer-fighting nutrients (i.e., fruits and vegetables), exercising, maintaining a healthy weight, reducing stress, and getting restful sleep can all help to lower cancer risk. Don’t smoke, and quit if you do. Drinking and smoking increase cancer risk more than either one alone.

The Bottom Line

The newest research makes one message clear: no amount of alcohol is completely safe. Even small or “moderate” amounts increase your risk of cancer and other serious health problems. If you choose to drink and want to decrease your chances of cancer and other serious health problems, try to drink less often and aim for a maximum average of 1 a day if you’re a woman and 2 a day if you’re a man.

All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.

The National Center for Health Research is a nonprofit, nonpartisan research, education and advocacy organization that analyzes and explains the latest medical research and speaks out on policies and programs. We do not accept funding from pharmaceutical companies or medical device manufacturers. Find out how you can support us here.

 

References

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  2. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov
  3. Centers for Disease Control and Prevention. Dietary Guidelines for Alcohol. Cdc.gov. https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm. Updated December 2020.
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