Alcohol-Attributable Cancer Mortality Has Doubled in the US Since 1990

Alcohol-attributable cancer deaths in the United States doubled from 11,361 in 1990 to 23,126 in 2023, according to a secondary analysis of Global Burden of Disease (GBD) data published in The Lancet Regional Health – Americas.¹

What were the key findings on alcohol-attributable cancer mortality?

Age-standardized mortality rates (ASMRs) increased from 3.8 per 100,000 population (95% CI, 1.7-6.9) in 1990 to 4.1 per 100,000 (95% CI, 2.7-5.8) in 2023. ASMRs increased in men by 14.3% but declined in women by 16% over the study period. Despite the ASMR decline among women, the percentage of ASMR attributable to alcohol increased substantially in both sexes (men, 92%; women, 16.7%). In 2023, most alcohol-attributable cancer deaths occurred in men (n = 17,477; ASMR, 6.4) and in individuals 55 years and older (n = 19,460; ASMR, 19.2).

Which cancer types and demographic groups had the greatest alcohol-attributable burden?

Liver cancer accounted for the most alcohol-attributable cancer deaths in 2023 (n = 7686; ASMR, 1.3), followed by esophageal (n = 4902; ASMR, 0.9) and colorectal cancer (n = 3818; ASMR, 0.7). The percentage of ASMR attributable to alcohol increased across nearly all cancer types except liver cancer; the largest relative increases were seen in stomach (57.2%), pancreatic (40.5%), and colorectal cancer (39.7%).

Liver cancer itself showed the greatest overall rise in ASMR from 1990 to 2023, increasing 113.9%, though the percentage of ASMR attributable to alcohol decreased by 0.6%. Among adults 55 years and older, liver cancer carried the highest alcohol-attributable mortality in men, while breast cancer ranked highest among women. In adults ages 20 to 54, colorectal cancer was the leading alcohol-attributable cause of cancer death in men; breast cancer ranked highest in women, followed by colorectal cancer.

“The most surprising finding was the breadth of alcohol's potential impact across cancer types,” stated Chinmay Jani, MD, corresponding author of the study and chief fellow in hematology and oncology at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, in a press release from the university.² “Although its relationship with liver cancer is widely recognized, its contribution to cancers such as colorectal, esophageal, breast, pancreatic, and prostate cancer is less well understood by the public.”

What state-level differences did the study identify?

The District of Columbia recorded the highest alcohol-attributable ASMR in 2023 (men, 9.8; women, 3.5), while Utah recorded the lowest (men, 3.9; women, 1.4). ASMR increased in 47 states among men, with the sharpest rises in Oklahoma (68.4%), New Mexico (64.2%), West Virginia (57.7%), and Tennessee (57.5%); the largest declines occurred in Washington DC (−25.8%), New Jersey (−15.5%), and New York (−12.3%). Among women, ASMR increased in 17 states, led by West Virginia (26.8%), Tennessee (20.4%), and Mississippi (16.8%); the largest declines were in Massachusetts (–37.5%), New York (–36.6%), and New Jersey (–36.3%).

How was the study designed?

A population-based observational trend analysis was completed using data from the GBD 2023 database. From 1990 to 2023, investigators extracted information that included total alcohol-attributable cancer deaths, ASMRs, and age group-specific mortality rates, and percentage of mortality rates attributable to alcohol for all cancer types. All mortality rates were reported per 100,000 population.

What is the study's clinical and public health significance?

Gilberto Lopes, MD, senior author of the study and chief of the division of medical oncology at the Miller School, stated, “What this study makes clear is that alcohol-related cancer risk is not limited to one disease or one group of people. As physicians and cancer researchers, we have an opportunity to help patients understand that alcohol is a modifiable risk factor and that even small, informed changes can be part of a broader strategy to reduce cancer risk.”²

The study authors noted that GBD data do not permit direct assessment of cumulative lifetime alcohol exposure and lack granular patient-level data on race, ethnicity, and social determinants of health, limiting the ability to evaluate disparities in alcohol-attributable cancer burden. The findings were first presented as an oral presentation at the 2025 American Society of Clinical Oncology Annual Meeting.³

References

1. Jani CT, Edwards K, Sharma R, et al. Alcohol-attributable cancer mortality in the United States, 1990–2023: a secondary analysis of Global Burden of Disease data. Lancet Reg Health Am. 2026:101599. doi:10.1016/j.lana.2026.101599
2. U.S. cancer deaths linked to alcohol have doubled since 1990, study finds. News release. University of Miami Miller School of Medicine. September 2, 2026. Accessed September 4, 2026. https://tinyurl.com/3nrsz52s
3. Jani C, Edwards K, Paudel A, et al. Escalating impact of alcohol-related cancer mortality in the US: A call for action. J Clin Oncol. 2025;43(suppl 16):10519. doi:10.1200/JCO.2025.43.16_suppl.10519