Reducing Alcohol Use to Prevent Cancer Deaths: Estimated Effects Among U.S. Adults
Research brief
What is the study about?
This study sheds light on alcohol-caused cancer deaths in the U.S. It highlights the potential for preventing a large number of cancer deaths. For this, people need to follow recommended alcohol usage limits.
The study’s findings align with the updated Dietary Guidelines for U.S. Americans, 2020–2025. Study findings also align with World Health Organization (WHO) and Canadian guidance.
How was the study conducted?
The study used national cancer mortality data from 2020–2021. Researchers looked at alcohol use prevalence levels and relative risks (RR) for different alcohol consumption levels and cancer sites.
There they categorized two scenarios.
- One included how many cancer deaths could be linked to alcohol if everyone consumed according to the Dietary Guidelines.
- The second scenario focused on heavy alcohol users who cut down to just one unit a day, following the guideline.
Key Findings
The study had two major findings. The contribution of alcohol to cancer mortality is something that can be prevented.
Projected drop in cancer mortality due to alcohol
During 2020–2021, about 602,000 people in the U.S. died from cancer. Among them, 20,000 deaths were linked to alcohol use (3.4%).
The most prevalent alcohol-related cancer deaths among men were from liver cancer. For women it was breast cancer.
If everyone consumed alcohol according to the Dietary Guidelines, 16,800 deaths could be prevented – meaning 83% of all alcohol-attributable cancer deaths.
Approximately 650 additional deaths could be prevented annually if men consumed 1 alcoholic drink/day, instead of 2.
These findings show that reducing alcohol consumption can significantly lower the risk of alcohol-related cancers, potentially saving thousands of lives each year.
Reducing alcohol use could save 5,102 lives from liver cancer for men. Putting a stop to alcohol could prevent 2,610 deaths from breast cancer among women.
Conclusion and meaning
An estimated 83% of the approximately 20,000 alcohol-attributable cancer deaths each year could have been prevented if adults who consumed more alcohol than the Dietary Guidelines syggest had instead consumed alcohol within the Dietary Guidelines recommendations.
Alcohol use is an under-recognized cancer risk factor and could be more widely included in comprehensive cancer control plans.
Like strategies to address other modifiable cancer risk factors (e.g., tobacco use), evidence-based policies that reduce the availability and affordability of alcohol (e.g., increasing alcohol taxes, reducing alcohol outlet density) can decrease alcohol use and alcohol-attributable cancers, complementing clinical interventions (e.g., alcohol screening and brief intervention).
Study limitations
This analysis assumed that the distributions of low-level alcohol consumption mirrored current population distributions and that the relative risks did not change in the two scenarios compared to the actual estimates; however, if adults reduced their alcohol use to low levels, distributions and relative risks might differ from these hypothetical scenarios.
Scenario 1 only approximates the Dietary Guidelines as alcohol prevalence estimates were based on mean consumption, whereas the Dietary Guidelines pertain to alcoholic drinks on alcohol consumption days.
Lastly, the alcohol prevalence estimates did not include adults who did not consume alcohol 30 days prior to the survey; however, some people who formerly consumed alcohol may have died from alcohol-attributable cancer, referred to as the sick-quitter effect.
Abstract
Introduction
The Dietary Guidelines for Americans, 2020–2025 recommends not to consume alcohol or no more than 2 alcoholic drinks for men or 1 alcoholic drink for women in a day. However, even at lower levels, alcohol use increases the risk for certain cancers.
This study estimated mean annual alcohol-attributable cancer deaths and the number of cancer deaths that could potentially be prevented if all U.S. adults who consumed more alcohol than the Dietary Guidelines suggest had instead consumed alcohol to correspond with typical consumption of those who drink alcohol within the recommended limits.
Methods
Among U.S. residents aged ≥20 years, mean annual alcohol-attributable cancer deaths during 2020–2021 that could have been prevented with hypothetical reductions in alcohol use were estimated.
Mean daily alcohol consumption prevalence estimates from the 2020–2021 Behavioral Risk Factor Surveillance System, adjusted to per capita alcohol sales to address underreporting of alcohol use, were applied to relative risks to calculate population-attributable fractions for cancers that can occur from consuming alcohol.
Analyses were conducted during February–April 2023.
Results
In the U.S., an estimated 20,216 cancer deaths were alcohol-attributable/year during 2020–2021 (men: 14,562 [72.0%]; women: 5,654 [28.0%]).
Approximately 16,800 deaths (83% of alcohol-attributable cancer deaths, 2.8% of all cancer deaths) could have been prevented/year if adults who drank alcohol above the Dietary Guidelines had instead reduced their consumption to ≤2 alcoholic drinks/day for men or ≤1 alcoholic drink/day for women.
Approximately 650 additional deaths could have been prevented annually if men consumed 1 alcoholic drink/day, instead of 2.
Conclusions
Implementing evidence-based alcohol policies (e.g., increasing alcohol taxes, regulating alcohol outlet density) to decrease alcohol use could reduce alcohol-attributable cancers, complementing clinical interventions.