Just One Drink a Day May Increase the Risk of Dying from Several Cancers

For years, a glass of wine with dinner or an evening cocktail was often described as harmless—and sometimes even healthy. But a growing body of research is challenging that belief. A new study examining more than three decades of U.S. data suggests that alcohol may contribute to more cancer deaths than many Americans realize, and that risk can begin at relatively low levels of consumption.

Q: What did the new study find?

The study found that although the overall cancer death rate in the United States has declined, the proportion of cancer deaths attributable to alcohol increased by more than 58% among adults age 20 and older between 1990 and 2023.

The annual number of alcohol-attributable cancer deaths more than doubled during that period, rising from 11,361 in 1990 to 23,126 in 2023.

Of the 10 cancers examined, prostate, pancreatic and stomach cancers showed the smallest increases in alcohol-attributable deaths. Even so, deaths attributed to alcohol increased over time for all three.

Researchers analyzed data from the Global Burden of Disease Study, a large international project that estimates illness, disability and death associated with hundreds of diseases and risk factors across more than 200 countries and territories.

Q: Can one drink a day really increase cancer risk?

Yes. Cancer risk is not limited to people who drink heavily. Evidence shows that even light drinking can increase the risk of certain cancers, particularly breast cancer in women. According to the National Cancer Institute, women who average one drink per day have a higher breast cancer risk than women who consume less than one drink per week.

This does not mean that everyone who has one drink a day will develop cancer. It means that, at the population level, the probability is higher than among people who drink very little or not at all. Risk generally increases as alcohol consumption increases.

It is also important to distinguish a “lower-risk” drinking limit from a risk-free amount. A limit may reduce harm compared with heavier drinking, but it does not guarantee safety from cancer.

Q: What counts as one standard drink?

In the United States, one standard drink contains approximately 14 grams of pure alcohol. That is roughly:

• 12 ounces of regular beer
• 5 ounces of wine
• 1.5 ounces of 80-proof distilled spirits

Many restaurant pours, large wine glasses, and mixed drinks contain more than one standard drink, so people may underestimate how much alcohol they consume.

Q: Which cancers are most clearly linked to alcohol?

Strong scientific evidence has established that alcohol causes at least seven types of cancer:

• Breast cancer in women
• Colorectal cancer
• Liver cancer
• Esophageal cancer
• Mouth cancer
• Throat cancer
• Laryngeal, or voice box, cancer

The new mortality analysis also examined alcohol-attributable deaths involving cancers such as pancreatic, prostate and stomach cancer. However, the evidence for a causal relationship is not equally strong for every cancer included in a disease-burden model. The National Cancer Institute describes the evidence for pancreatic, prostate and stomach cancers as suggestive rather than as firmly established as it is for the seven cancers listed above.

Alcohol also played a major role in deaths from malignant tumors of the head and neck, including cancers of the lip, oral cavity, pharynx and larynx, as well as esophageal cancer. According to the study’s lead author, alcohol is a risk factor in as many as one-quarter of head and neck cancers—highlighting an important opportunity for prevention.

Q: Which cancers accounted for the most alcohol-related deaths?

The pattern differed by age and sex.

Among adults ages 20 to 54, colorectal cancer was the leading cause of alcohol-attributable cancer death in men and the second-leading cause in women. It surpassed liver cancer in both groups. Among women in this age range, breast cancer was the leading cause.

Adults age 55 and older—especially older men—experienced the greatest overall burden. In men, liver cancer had the strongest link to alcohol-attributable mortality, followed by esophageal and colorectal cancers. Among women age 55 and older, breast cancer ranked first, followed by liver and colorectal cancers.

Q: Why does alcohol increase cancer risk?

Alcohol can contribute to cancer through several biological pathways.

First, the body breaks ethanol down into acetaldehyde, a toxic chemical and probable human carcinogen. Acetaldehyde can damage DNA and proteins and interfere with the body’s ability to repair that damage.

Alcohol can also:

• Generate oxidative stress that damages cells, proteins, and DNA
• Increase inflammation
• Raise estrogen levels, which can promote the development of some breast cancers
• Reduce the body’s ability to absorb nutrients associated with cancer protection, including folate and vitamins A, C, D, and E
• Make tissues in the mouth and throat more vulnerable to cancer-causing substances

The combination of alcohol and tobacco is especially dangerous. Together, they multiply the risk of cancers of the mouth, throat, larynx and esophagus beyond the risk associated with either substance alone.

Q: Why may the effects differ for women and men?

Women can reach higher blood alcohol concentrations than men after consuming the same amount of alcohol, partly because of average differences in body water, body composition and alcohol metabolism. Alcohol also raises estrogen levels, which is one reason breast cancer is a particular concern.

The study’s researchers reported that women of any age and men younger than 55 may reach higher modeled cancer-risk levels at lower amounts of alcohol than older men. Individual risk still varies according to genetics, medical history, tobacco use, drinking pattern, and total lifetime exposure.

Q: Is wine safer than beer or liquor?

No type of alcoholic beverage is cancer-free. Beer, wine, and liquor all contain ethanol, the ingredient responsible for alcohol-related cancer risk. Red wine contains compounds such as resveratrol, but research has not shown that drinking red wine prevents cancer or offsets alcohol’s harmful effects.

Q: Does this mean there is no completely safe amount of alcohol?

When it comes to cancer, no amount of alcohol can be considered completely risk-free. The risk from an occasional drink is lower than the risk from daily or heavy drinking, but “lower risk” is not the same as “no risk.” For some cancers—especially breast cancer—risk can rise even with light consumption.

This is a dose-response relationship: in general, the more alcohol a person consumes over time, the greater the risk. Cutting back therefore has value even if a person does not stop entirely.

Q: Will reducing or stopping alcohol lower cancer risk?

Yes. Research suggests that stopping alcohol use is associated with lower risks of cancers of the mouth and esophagus and possibly lower risks of throat, breast and colorectal cancers. The reduction may take years, and former drinkers may not immediately return to the risk level of someone who has never consumed alcohol. Even so, it is never too late to reduce consumption.

Practical first steps may include measuring home pours, adding alcohol-free days each week, replacing the daily drink with a nonalcoholic option, and avoiding situations that reliably lead to overdrinking.

Anyone who drinks heavily or has experienced withdrawal symptoms should seek medical guidance before stopping suddenly, because alcohol withdrawal can be dangerous.

Q: What is the most important takeaway?

Alcohol is a preventable cancer risk factor, and the risk is not confined to people with alcohol addiction or very heavy drinking patterns. Even one drink a day may increase the likelihood of developing or dying from certain cancers.

The goal is not to create fear or shame. It is to give people accurate information so they can make informed decisions. Drinking less reduces risk, and not drinking eliminates alcohol-related cancer exposure altogether.

The researchers cautioned that their study was not designed to determine whether every person should stop drinking completely. Their practical message was simpler: lowering alcohol consumption to the lowest possible level is best for health.

This article is for educational purposes and is not a substitute for individualized medical advice. Anyone concerned about alcohol use, cancer risk, or withdrawal should consult a qualified health care professional.

Sources

• The Lancet Regional Health – Americas study
• National Cancer Institute: Alcohol and Cancer Risk
• U.S. Surgeon General’s Advisory on Alcohol and Cancer Risk
• CDC: Alcohol Use and Your Health

Expert Counseling and Coaching Services for Your Sobriety

Taking a break from alcohol can have profound benefits for your health and well-being. Whether you participate in Dry January or plan a more extended hiatus, you’ll reap rewards like improved relationships, cost savings, and better health. Considering the Surgeon General’s advice, making a temporary or permanent change to your habits can lead to a happier, healthier, and more fulfilling life.

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At R&A Therapeutic Partners, Raymond Estefania and Ana Moreno specialize in substance use and mental health disorder evaluations, treatment, intervention, and therapeutic/educational consulting for clients throughout the greater South Florida area, as well as nationally and internationally. For more resources and information, please visit Therapeutic-Partners.com or.

At R&A Therapeutic Partners Raymond Estefania and Ana Moreno specialize in substance use and mental health disorder evaluations, treatment, intervention and therapeutic/educational consulting for clients throughout the greater South Florida area, as well as nationally and internationally. For more resources and information please visit Therapeutic-Partners.com or on Facebook.