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Dr. Vivek Murthy, the U.S. Surgeon General, said Americans need to know there's a link between alcohol and cancer, citing four recent studies.
Murthy said all alcoholic beverages should have cancer warning labels on them, a measure Congress would have to design and approve.
In a new report, published January 3, Murthy outlined the research that persuaded him — and other medical professionals — that alcohol is a serious and under-appreciated health concern.
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Here's the data that backs up Murthy's advisory, with some caveats:
There are four ways alcohol causes cancer, Murthy said, citing a 2021 Nutrients study.
The first two are widely accepted, he wrote. Most physicians agree that when alcohol breaks down in the body it can bind to DNA, damaging cells and fueling tumors. There is also robust evidence that alcohol can drive inflammation, which is linked to cancer.
The study points to newer research that suggests alcohol may influence hormones like estrogen, paving the way to breast cancer, though it's not exactly clear how.
Another emerging idea is that alcohol seems to provide a literal melting pot for other toxins. Tobacco, for example, dissolves in alcohol, which could make it easier for the body to ingest, the study says.
To back up his argument for warning labels, Murthy pointed to a 2015 meta-analysis published in the British Journal of Cancer, which found "a significant relationship" between alcohol consumption and seven cancers.
The team of researchers from Italy, the US, France, Sweden, and Iran examined data from 572 studies, featuring 486,538 cancer cases. They compared the cancer risk of heavy drinkers with occasional drinkers and nondrinkers.
They found heavy drinking was linked to cancers of the mouth, throat, esophagus, colorectum, liver, larynx, and breast.
Murthy also referenced a 2020 study, published in Nature, that specifically looked at alcohol as a risk factor for head and neck cancer.
The research on around 40,000 people in 26 studies found higher-intensity drinking — consuming more drinks per day, and drinking more years in a lifetime — was correlated with higher risk of head and neck cancers.
The third significant study that Murthy highlighted was a 2018 global systematic analysis looking at alcohol-related deaths in 195 countries over the course of 26 years. That report, published in The Lancet, concluded that there is no safe level of alcohol consumption when it comes to cancer.
Each report has caveats. For example, the 2015 meta-analysis used varying measurements of alcohol and the 2018 study did not differentiate between drinking patterns, such as binge-drinking or moderate drinking.
Still, the studies are comprehensive, significant, and have informed many of the physicians who say that alcohol is a serious health concern.
Murthy said he was motivated to publish this report because surveys suggest more than half of Americans do not recognize a link between alcohol and cancer.
The science on alcohol is not cut-and-dry, though.
Some of the healthiest people in the world — in the Mediterranean and so-called Blue Zones — drink wine daily. Researchers believe the social aspect of alcohol may have strong benefits for longevity.
Plus, Murthy's report clashes with a major report by the National Academies of Sciences, Engineering, and Medicine, which was published in December.
The paper, which will be used to inform the new 2025 Dietary Guidelines, found that moderate drinkers have a lower risk of premature death from heart attack and stroke than people who don't drink at all. It also found an increased risk in breast cancer.
The Department of Health and Human Services is due to publish its own analysis of the latest science on alcohol in the coming weeks.
