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In early 2025, many Americans began their quest for a healthier year by committing to more exercise, a renewed focus on mental wellbeing, a healthier diet and “Dry January” (i.e. a month without alcohol consumption). Then, U.S. Surgeon General Vivek Murthy issued his latest opinion linking alcohol to increased cancer risk.
Specifically, the advisory highlighted an increased risk in the mouth, throat, esophagus, voice box, breast (in women), liver, colon and rectum. cancers in those who consume any amount of alcohol. Additionally, the report states that alcohol consumption leads to 100,000 cancer cases and 20,000 cancer-related deaths in the United States each year, making it the third leading preventable cause of cancer after tobacco and obesity.
I believe many of us have a long time the suspected alcohol was not necessarily “good” for us. But what I think we didn’t know – or perhaps didn’t want to fully recognize – was how bad it could be for our health. In fact, 60% of Americans say they are unaware of the link between alcohol and cancer. Hopefully this notice begins the process of educating the public about this important health connection.
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Since the advisory was released, Americans have raised many questions about what the government might do next, what the results mean for them, and how they should consider these findings in their daily lives.
Most Americans knew of no connection between alcohol and cancer. (AP Photo/David J. Phillip, file)
Here’s what you need to know and keep in mind.
How does alcohol cause cancer?
At a height of 30,000 feet, alcohol damages your DNA, increasing your risk of cancer. This happens through several different mechanisms. For example, our DNA can be damaged by acetaldehyde, the toxic metabolite of alcohol that is broken down in our bodies, or by oxidative stress caused by alcohol.
Alcohol also changes the levels of hormones in our bodies, such as estrogen, which likely explains the relationship between alcohol and increased risk of breast cancer. Not only does alcohol directly damage our DNA, but it also increases the absorption of cancer-causing, or carcinogenic, chemicals into the body. So while we may think that a glass of wine or beer is calming or relaxing to our body, it actually does the exact opposite, causing inflammation.
What comes next?
The advisory lays the groundwork for action – from the government, from doctors, and from our fellow Americans.
Murthy suggests the surgeon general’s warning label on alcohol be updated to clearly state the link between alcohol and cancer. Such a labeling change would require an act of Congress, and I believe it should be done quickly on a bipartisan basis. What’s one thing we can all rally behind? Reduce cancer among our family, friends and neighbors.
However, this is not a miracle strategy. While one study evaluating warning labels on cigarettes found that more comprehensive, larger and more graphic labels better communicate the health risks of smoking to the public, another suggested that they did not of real effect on smoking behavior.
So if we extrapolate what this may mean to the future impact of an update to the Surgeon General’s alcohol warning label, the effect could be minimal. Furthermore, it is important to note that this is the result even though the cancer risk is significantly higher for cigarettes than for alcohol when consumed in comparable quantities.
But updating the warning label is the start of the education needed to raise public awareness and build physician buy-in, which Murthy also highlights as important “action items.” We must work collaboratively to increase knowledge about the relationship between alcohol and cancer risk, not only in the media but in more personal settings, such as doctors’ offices and within our local communities. A targeted strategy is needed to harness the potential of an educational program to reduce alcohol consumption.
Surgeon General Dr. Vivek H. Murthy has warned of a serious link between alcohol and cancer. FILE: Murthy speaks on stage at the Archewell Foundation Parent Summit on October 10, 2023, in New York. (Bryan Bedder/Getty Images for the Healthy Minds Project)
Finally, we must always ensure that policy follows the latest scientific advances. It’s okay not to know, but we need to be clear to the public when we do. For example, the current definition of moderate drinking (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 liquor]) is relatively arbitrary and its use as a “scientific” guide can be misleading and confusing. As Murthy pointed out, we need to reevaluate these definitions of “thresholds.”
What are the limits of what we know?
Although current research overwhelmingly demonstrates a link between alcohol consumption and cancer, the details of what we don’t know also matter. Data suggests that cancer risk is directly proportional to the amount of alcohol consumed, meaning that if you drink more alcohol, your cancer risk increases. It makes sense: alcohol is a toxin and the more toxins you put into your body, the worse it will be for you.
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But is it only the quantity that counts? Does the risk differ depending on the “quality” of the alcohol (e.g., natural wine or high-quality wine versus wine with more additives) or type of alcohol? Is there a “safe” limit? What role do genetics play? Do other preventative measures, such as a healthy, healthy diet and exercise, “offset” your alcohol-related cancer risk, and – if so – by how much?
These questions only highlight part 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 this shows is that there is still a lot of research to be done, particularly to reduce some of the biases, or confounding factors, in the data currently used. This ensures that the most comprehensive evidence is available to guide education and policy development.
At a height of 30,000 feet, alcohol damages your DNA, increasing your risk of cancer.
So what does all this mean for you?
We should applaud Murthy for bringing this information into the national spotlight. Information is power, and now – after reading this article – I am confident that you can make a more informed decision for yourself about how much and how often to drink alcohol.
From my perspective, I firmly believe that moderation is key, and I will continue to emphasize this as a doctor and follow this approach in my own life. While many may stop drinking alcohol altogether after this advisory is published, I urge everyone else to strive to moderate their consumption.
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Personally, I’ll always enjoy a social beer here or a glass of wine there. At the same time, I plan to reduce my alcohol consumption overall. It’s an individual decision, and as a cancer survivor (testicular cancer) myself, I always want to “live my life”.
Ultimately, I challenge us all to take one step every day to be 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 those of the author alone and not necessarily those of the employers or institutions with which he is affiliated.
