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When 2025 started, many Americans started getting their… quest for a healthier year moving forward by committing to more exercise, a renewed focus on mental wellbeing, a healthier diet and ‘Dry January’ (i.e. a month without alcohol consumption). That’s when U.S. Surgeon General Vivek Murthy issued his latest advisory linking alcohol to an increased risk of cancer.
The advice specifically pointed out an increased risk in the mouth, throat, esophagus, voice box, breast (in women), liver and large intestine and rectum. cancer among those who consume any amount of alcohol. Furthermore, the report states that alcohol consumption leads to 100,000 cancer cases and 20,000 cancer-related deaths each year in the US, making it the third leading preventable cause of cancer after tobacco and obesity.
I believe many of us take a long time suspected alcohol was not necessarily ‘good’ for us. But what I don’t think we knew – or perhaps didn’t want to fully acknowledge – was how bad it could be for our health. In fact, 60% of Americans say they are unaware of the relationship between alcohol and cancer. Hopefully this advisory begins the process of educating the public about this important health-related link.
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Since the advisory’s publication, Americans have raised numerous questions about what the government could do next, what the findings mean for them, and how they should consider the findings in their daily lives.
Most Americans were unaware of any link between alcohol and cancer. (AP Photo/David J. Phillip, file)
Here you can read what you need to know and what to take into account.
How does alcohol cause cancer?
From a 30,000-foot perspective, alcohol damages your DNA, increasing your risk of cancer. This happens through various mechanisms. For example, our DNA can be damaged by acetaldehyde, the toxic metabolite alcohol is broken down in our body or by the oxidative stress that alcohol causes.
Alcohol also changes hormone levels in our bodies, such as estrogen, which likely explains alcohol’s relationship with an increased risk of breast cancer. Alcohol not only directly damages our DNA, but it also increases the absorption of cancer-causing chemicals, or carcinogens, into the body. So while we might think that a glass of wine or beer is calming or relaxing for our bodies, it actually does the exact opposite: it causes inflammation.
What comes next?
The advice lays the foundation for action – by the government, doctors and our fellow Americans.
Murthy proposes that the surgeon general’s warning label on alcohol be updated to clearly indicate the link between alcohol and cancer. Such a labeling change would require an act of Congress, and I believe this should happen quickly and on a bipartisan basis. What’s one thing we can all get behind? Reducing cancer among our family, friends and neighbors.
However, this is not a “silver bullet” strategy. While one study of cigarette warning labels found that more elaborate, larger and graphic labels better communicate the health risks of smoking to the public, another study suggested that they had no actual effect on smoking behavior.
So if we extrapolate what this could mean for the future impact of an updated Surgeon General’s warning label on alcohol, the effect could be nominal. Furthermore, it is important to note that this was the result despite the fact that the risk of cancer is significantly higher for cigarettes than for alcohol when consumed in comparable amounts.
But updating the warning label is a start to the education needed to increase general awareness and physician buy-in, which Murthy also emphasizes are important “action items.” We need to work together to increase knowledge about the relationship between alcohol and cancer, not only in the media, but also in more personal settings, such as doctors’ offices and in our local communities. A targeted strategy is needed to realize the potential of an education program to reduce alcohol consumption.
Surgeon General Dr. Vivek H. Murthy warned of a serious link between alcohol and cancer. FILE: Murthy speaks onstage at the Archewell Foundation Parents’ Summit on Oct. 10, 2023, in New York City. (Bryan Bedder/Getty Images for Project Healthy Minds)
Finally, we must always ensure that policy follows the latest, current science. It’s okay not to know, but we need to be clear with the public when that is the case. The current definition of moderate alcohol consumption (one drink or less per day for women and two drinks or less per day for men (one drink is 12 ounces of beer, five ounces of wine, or 1.5 ounces of spirits)) is relatively arbitrary and the use as a ‘scientific’ guide can be misleading and confusing. As Murthy noted, we need to reassess this definition of “cut-offs.”
What are some of the limits of what we know?
While current research overwhelmingly shows a link between alcohol consumption and cancer, the details of what we don’t know also matter. There is evidence that the risk of cancer is directly proportional to the amount of alcohol consumed, meaning that as you drink more alcohol, your risk of cancer increases. This makes sense: alcohol is a toxin and the more toxins you put into your body, the worse it should be for you.
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But is it only the quantity that counts? Does the risk differ by alcohol quality (for example, a natural wine or a high-quality wine versus a wine with more additives) or the type of alcohol? Is there a ‘safe’ limit? What role does genetics play? Can other preventive measures, such as a healthy, healthy diet and sufficient exercise, ‘compensate’ for the risk of cancer due to alcohol consumption, and – if so – to what extent?
These questions only highlight some of what we don’t know, and it’s important to note that they don’t discredit the central fact: alcohol and cancer are directly linked. But what it does show is that more research needs to be done, especially to reduce some of the bias, or confounding factors, in the current data used so far. This ensures that the most complete evidence is available to guide education and policy making.
From a 30,000-foot perspective, alcohol damages your DNA, increasing your risk of cancer.
What does this all mean to you?
We must commend Murthy for bringing this information into the national spotlight. Information is empowering, and now – after reading this piece – I’m confident you can make a more informed decision about how much and how often to drink alcohol.
From my perspective, I strongly believe that moderation is key, and I will continue to emphasize this as a physician and take this approach in my own life. While many may stop drinking alcohol altogether following the publication of this advice, I urge everyone else to strive to moderate their intake.
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Personally, I will still enjoy a nice beer here or a glass of wine there. At the same time, however, I plan to reduce my alcohol consumption in general. It’s an individual decision, and as a cancer survivor (testicular cancer) myself, I still want to “live my life”.
Ultimately, I challenge us all to take a step every day to become a little healthier: eat better, drink less, exercise more and support our mental and spiritual health and well-being.
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The opinions, thoughts and ideas expressed in this article are solely those of the author and not necessarily those of employers or institutions with which he is affiliated.
