Just one drink a day may increase the risk of dying from numerous cancers

Alcohol may play a greater role in death from numerous types of cancers in the United States than previously known, according to a new study.

“While it’s true that overall cancer mortality has declined, we found the percentage of cancer deaths proportionally attributable to alcohol doubled in people 20 and older over the last 33 years,” said the study’s first author Dr. Chinmay Jani.

The increased risk of death applies to breast, prostate, colon, rectum, stomach, pancreatic and liver cancers, as well as cancers of the head and neck, the research found.

“Overall, we know alcohol is closely related to liver cancer mortality,” said Jani, chief clinical fellow in hematology and oncology at the Sylvester Comprehensive Cancer Center of the University of Miami.

“Notably, among adults aged 20 to 54, colorectal cancer was the leading cause of alcohol-attributable cancer mortality in men and the second leading cause in women, surpassing liver cancer in both groups,” he said. “In women, the leading cause was alcohol-related breast cancer.”

It didn’t take much alcohol to raise one’s risk — about one standard drink a day, every day, Jani said. In the US, a standard drink is 12 ounces of regular beer, 5 ounces of wine or 1.5 ounces of 80-proof liquor.

For decades, federal guidelines have recommended that Americans limit their drinking to two standard drinks a day for men and one drink a day for women. In January, the Trump administration removed those limits, instead suggesting that people should “ consume less alcohol for better overall health .”

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While having a cocktail each evening was once considered to be an acceptable part of daily life, studies today show that’s an outdated belief, said cardiologist Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver.

“What we used to think about alcohol continues to be eroded as modern science has shown us that there is no safe amount of alcohol consumption,” said Freeman, who was not involved with the new research. “This study in concert with several others suggests that the risks associated with consumption need much wider recognition.”

Alcohol contributes to cancer growth in several ways, according to the National Cancer Institute , or NCI. Alcohol alters levels of hormones, including estrogen, a key reason for the link between drinking and breast cancer.

Alcohol is ethanol or ethyl alcohol, which is broken down by the liver into acetaldehyde, a “probable human carcinogen,” the NCI states on its website. While the liver will further break down acetaldehyde into a harmless molecule called acetate, the process isn’t foolproof: acetaldehyde may damage DNA and interfere with DNA repair before conversion into acetate is complete.

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Alcohol also contributes to oxidative stress, which damages DNA, proteins and cell function and creates inflammation. Drinking alcohol also weakens the cells in the mouth and throat, making them more susceptible to carcinogens. That’s even more likely to occur with smoking cigarettes, a major source of acetaldehyde.

In addition, alcohol interferes with the break down and absorption of key nutrients thought to decrease cancer risk — vitamins A, C, D and E as well as folates in the vitamin B complex, according to NCI.

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The study, which was published Monday in The Lancet Regional Health – Americas journal, analyzed more than three decades of US data gathered for the Global Burden of Disease Study. The GBD study is a massive scientific effort to measure health, mortality and disabilities from hundreds of risk factors, diseases and conditions in more than 200 countries and territories.

Between 1990 and 2023, the total number of yearly alcohol-linked cancer deaths more than doubled, rising from 11,361 to 23,126 in the US.

Men and adults age 55 and older experienced the greatest impact; alcohol-related cancer mortality rate in older males climbed nearly 24% over the 33-year period. For men, liver cancer deaths showed the strongest link to alcohol, followed by esophageal and colorectal cancers. For women 55 and older, breast cancer was the top killer, followed by liver and colorectal cancers.

For women of any age, and for men younger than age 55, it takes less alcohol to raise of risk of cancer compared with men older than 55, according to Jani. “If the same proportion of alcohol is taken by a female or by a younger male or female, it’s considered a much higher risk potential for cancer development,” he said.

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Of the 10 cancers the study examined, the smallest increases in alcohol-linked deaths were in prostate, pancreatic and stomach cancers, but even those went up over time, Jani said.

Alcohol played a major role in deaths from malignant tumors in the head and neck, including lip, oral cavity, pharynx, larynx and cancer of the esophagus. Up to one-fourth of head and neck cancers have alcohol as a risk factor, “which obviously could be prevented,” Jani said.

“While our study does not have the data to show you should completely stop drinking alcohol, the message we want to deliver is that lowering your alcohol use to the lowest possible level will be best for your health.”

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一项新研究表明，酒精在美国多种癌症死亡病例中所起的作用可能比之前所知的更大。

“虽然总体癌症死亡率确实有所下降，但我们发现，在过去 33 年里，20 岁及以上人群中，因饮酒导致的癌症死亡比例翻了一番，”该研究的第一作者 Chinmay Jani 博士说。

研究发现，死亡风险增加适用于乳腺癌、前列腺癌、结肠癌、直肠癌、胃癌、胰腺癌和肝癌，以及头颈癌。

“总的来说，我们知道酒精与肝癌死亡率密切相关，”迈阿密大学西尔维斯特综合癌症中心血液学和肿瘤学首席临床研究员贾尼说。

“值得注意的是，在20至54岁的成年人中，结直肠癌是男性因饮酒导致的癌症死亡的首要原因，也是女性的第二大原因，在这两个群体中均超过了肝癌，”他说道。“在女性中，首要原因是与酒精相关的乳腺癌。”

贾尼说，其实每天只需少量饮酒就会增加患病风险——大约每天一杯标准饮品就足够了。在美国，一杯标准饮品相当于12盎司普通啤酒、5盎司葡萄酒或1.5盎司80度烈酒。

几十年来，联邦指南一直建议美国人饮酒量限制在男性每天两杯标准饮品以内，女性每天一杯标准饮品以内。今年1月，特朗普政府取消了这些限制，转而建议人们“为了整体健康，应该减少饮酒量”。

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预计到2050年，全球乳腺癌病例将超过350万例。

丹佛国家犹太健康中心心血管预防和健康主任、心脏病专家安德鲁·弗里曼博士表示，虽然过去人们认为每晚喝一杯鸡尾酒是日常生活中可以接受的一部分，但如今的研究表明，这是一种过时的观念。

“现代科学已经证明，饮酒没有安全剂量，我们过去对酒精的看法正在不断被颠覆，”弗里曼说道，他并未参与这项新研究。“这项研究以及其他几项研究都表明，饮酒带来的风险需要得到更广泛的重视。”

根据美国国家癌症研究所（NCI）的说法，酒精会以多种方式促进癌症的生长。酒精会改变激素水平，包括雌激素水平，这是饮酒与乳腺癌之间存在联系的关键原因。

酒精指的是乙醇或酒精，它会在肝脏中分解成乙醛，美国国家癌症研究所（NCI）在其网站上指出，乙醛是一种“可能的人类致癌物”。虽然肝脏会将乙醛进一步分解成一种名为乙酸盐的无害分子，但这个过程并非万无一失：在完全转化为乙酸盐之前，乙醛可能会损伤DNA并干扰DNA修复。

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酒精还会导致氧化应激，从而损伤DNA、蛋白质和细胞功能，并引发炎症。饮酒还会削弱口腔和咽喉细胞，使其更容易受到致癌物的侵害。吸烟会加剧这种情况，因为香烟是乙醛的主要来源之一。

此外，据美国国家癌症研究所 (NCI) 称，酒精还会干扰被认为可以降低癌症风险的关键营养素（维生素 A、C、D 和 E 以及维生素 B 族中的叶酸）的分解和吸收。

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这项研究于周一发表在《柳叶刀区域健康——美洲》杂志上，分析了美国三十多年来为全球疾病负担研究（GBD）收集的数据。GBD研究是一项大规模的科学项目，旨在衡量200多个国家和地区数百种风险因素、疾病和病症对健康、死亡率和残疾的影响。

从 1990 年到 2023 年，美国每年与酒精相关的癌症死亡人数增加了一倍多，从 11361 人上升到 23126 人。

男性和55岁及以上人群受到的影响最大；在33年间，老年男性因酒精导致的癌症死亡率上升了近24%。在男性中，肝癌死亡与酒精的关联最为密切，其次是食管癌和结直肠癌。在55岁及以上女性中，乳腺癌是首要致死原因，其次是肝癌和结直肠癌。

据贾尼称，对于任何年龄的女性以及55岁以下的男性来说，与55岁以上的男性相比，更少的酒精就能增加患癌风险。“如果女性或更年轻的男性或女性饮用相同比例的酒精，那么他们患癌的风险要高得多，”他说道。

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越来越多的女性从未接受过宫颈癌筛查。以下是相关风险。

Jani表示，在研究调查的10种癌症中，与酒精相关的死亡人数增幅最小的是前列腺癌、胰腺癌和胃癌，但即使是这些癌症，其死亡人数也随着时间的推移而上升。

酒精在头颈部恶性肿瘤（包括唇癌、口腔癌、咽癌、喉癌和食道癌）的死亡病例中扮演了重要角色。贾尼说，高达四分之一的头颈部癌症病例都将酒精作为危险因素，“这显然是可以预防的”。

“虽然我们的研究没有数据表明你应该完全停止饮酒，但我们想要传达的信息是，将你的饮酒量降低到尽可能低的水平对你的健康最有益。”

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