The estimated rate of alcohol-attributable cancer mortality in the United States doubled from 1990 to 2023, while the age-standardized mortality rate increased from 3.8 to 4.1 per 100,000 individuals, according to a population-based observational analysis.
Investigators analyzed 1990 to 2023 Global Burden of Disease data, examining total alcohol-attributable, age-standardized, and age-specific cancer mortality rates. The analysis included all cancers combined and 10 individual cancer types at national and state levels, with national estimates further stratified by sex and age.
The Global Burden of Disease framework combined modeled alcohol exposure with relative risk estimates to calculate population-attributable fractions using a theoretical minimum risk exposure level. The investigators used Joinpoint regression to assess temporal trends and identify changes over time.
Estimated alcohol-attributable cancer mortality increased from 11,361 in 1990 to 23,126 in 2023. Age-standardized mortality increased 14% among male participants and decreased 16% among female participants. The percentage of the age-standardized mortality rate attributable to alcohol increased from 2.5% to 4.8% among male participants and from 1.8% to 2.0% among female participants, representing relative increases of 92% and 17%, respectively.
In 2023, 17,477 estimated alcohol-attributable cancer mortalities occurred among male participants, and 19,460 occurred among those aged 55 years or older. Hepatic, esophageal, and colorectal cancers accounted for 7,686, 4,902 and 3,818 mortalities.
The highest alcohol-attributable mortality rates included colorectal cancer among male participants aged 20 to 54 years, hepatic cancer among male participants aged 55 years and older, breast cancer among female participants aged 20 to 54 years, and breast cancer among female participants aged 55 years and older.
In a post hoc analysis, overall cancer mortality declined 34% among male participants aged 20 to 54 years while alcohol-attributable cancer mortality increased 14%. Among female participants in the same age group, overall cancer mortality declined 29% and alcohol-attributable cancer mortality declined by 17%.
The investigators reported limitations related to incomplete exposure data and variability among data sources; the latter could introduce input and measurement bias. They noted that age- and sex-splitting procedures could introduce additional uncertainty. The Global Burden of Disease database lacked granular patient-level data on race, ethnicity, and broader social determinants of health, limiting the ability to assess disparities. The observational design precluded causal inference beyond established risk factor–outcome relationships.
“Alcohol remains a leading yet modifiable risk factor for cancer,” wrote lead study author Chinmay T. Jani, of the Sylvester Comprehensive Cancer Center at the University of Miami/Jackson Health System, and colleagues.
The study received no funding. Justin Salciccioli reported work contracts and stock options from Upstream Bio. The study authors reported no other conflicts of interest.
