A sweeping review from Florida Atlantic University finds that how often and how much people drink alcohol can significantly raise their risk for several cancers, even at moderate levels. The study highlights who is most vulnerable and calls for stronger prevention strategies.
As holiday parties and end-of-year toasts fill calendars across the country, new research from Florida Atlantic University is offering a sobering reminder: even moderate drinking can raise the risk of several common cancers.
Researchers from FAU’s Charles E. Schmidt College of Medicine conducted a large systematic review of existing studies to better understand how different patterns of alcohol use affect cancer risk among U.S. adults. They examined 62 studies that together included samples ranging from dozens of people to nearly 100 million, and looked closely at both how much people drink and how often they drink.
Their conclusion: cancer risk climbs as alcohol intake goes up, and the pattern holds across a range of cancers.
Senior author Lea Sacca, an assistant professor of population health, and her colleagues report that alcohol use is linked to higher risk for breast, colorectal, liver, oral, laryngeal, esophageal and gastric cancers. Alcohol use also appears to worsen outcomes once cancer develops, as seen with alcoholic liver disease being associated with more advanced liver cancer and lower survival.
The team’s findings, published in the journal Cancer Epidemiology, reinforce a message that public health experts have been sounding for years: there is no completely risk-free level of drinking when it comes to cancer.
Across the studies they reviewed, the researchers found that both the quantity of alcohol consumed and the frequency of drinking matter. Heavy, daily or binge drinking showed particularly strong links to multiple cancers. But even mild and moderate drinking contributed to elevated risk, especially when combined with other health problems or risk factors.
The review also highlights that alcohol-related cancer risk is not evenly distributed. Certain groups appear to be hit harder than others.
The researchers found that higher alcohol intake increased risk especially for African Americans, people with genetic predispositions to cancer, and individuals with obesity or diabetes. Factors such as race, age, education and income influenced both exposure to alcohol and vulnerability to its effects, leaving some lower-income and racial or ethnic groups disproportionately affected even when they drank the same amount or less than others.
In other words, the same number of drinks can carry different risks depending on who you are and what else is going on with your health and environment.
“Across 50 studies in our review, higher alcohol consumption consistently raised cancer risk, with risk increasing as intake grows,” Sacca said in a news release. “Factors like type of alcohol, age of first exposure, gender, race, smoking, family history, and genetics all influence risk. Certain groups – older adults, socioeconomically disadvantaged individuals, and those with comorbidities – are especially vulnerable. Heavy, daily or binge drinking is strongly linked to multiple cancers, highlighting the importance of moderation and following cancer prevention guidelines.”
The type of alcoholic beverage may also play a role. In some studies, white wine or beer was linked to higher risk of certain cancers, while liquor often was not. The reasons for these differences are not fully clear and may involve other lifestyle habits that tend to go along with particular drinks.
Gender patterns emerged as well. Frequent drinking appeared to increase cancer risk in men, while episodic heavy drinking posed higher risk in women. Smoking amplified alcohol-related cancer risk in both sexes, though the exact effects varied by sex and drinking level.
Beyond alcohol and tobacco, the review identified a web of additional risk factors that can interact with drinking. These included high or low body mass index, low physical activity, poor diet, hormone use, carcinogenic infections such as hepatitis B and C, HPV, HIV and H. pylori, and even characteristics like specific hair or eye color. Ultraviolet exposure was tied to melanoma risk at body sites that typically receive less sun, suggesting complex interactions between lifestyle, environment and biology.
On the biological level, the mechanisms are well established. Co-author Lewis S. Nelson, the dean and chief of health affairs in the Schmidt College of Medicine, explained that alcohol can directly and indirectly damage the body in ways that promote cancer.
“Biologically, alcohol can damage DNA through acetaldehyde, alter hormone levels, trigger oxidative stress, suppress the immune system, and increase carcinogen absorption,” Nelson said in the news release.. “These effects are compounded by pre-existing health conditions, lifestyle choices, and genetic predispositions, all of which can accelerate cancer development.”
The FAU team also examined how following broader healthy-living recommendations affects risk. They found that people who adhered to American Cancer Society guidelines on alcohol and other lifestyle factors had lower cancer risk and lower mortality. That suggests that cutting back on drinking works best when it is part of a package of changes that also includes physical activity, a balanced diet and managing chronic conditions.
The researchers argue that the evidence now strongly supports more targeted prevention efforts. The researchers suggest targeted strategies such as tailored public health messaging, strengthened alcohol policies, and focused interventions for high-risk groups, which could meaningfully reduce alcohol-related cancer burden.
That could mean clearer warnings about cancer on alcohol labels, campaigns that explain risk in plain language, and screening in medical settings that takes into account both drinking patterns and social and medical vulnerabilities.
The review also underscores that alcohol’s impact is shaped by more than individual choice. It is tied to social conditions, access to health care, cultural norms and marketing, all of which influence who drinks, how much and with what consequences.
For individuals, the findings offer both a caution and an opportunity. Knowing that risk rises with each additional drink, people can make more informed decisions about how often and how much they consume. For those already living with conditions like obesity, diabetes or chronic liver disease, the research suggests that cutting back on alcohol may be especially important.
For clinicians and policymakers, the study provides a roadmap for where to focus attention: on high-risk groups, on combined risk factors such as smoking plus drinking, and on policies that make it easier for people to choose lower-risk options.
As Americans raise their glasses this season, the FAU researchers hope their work will prompt a moment of reflection. Alcohol is woven into many celebrations and social rituals, but it is also a modifiable cancer risk factor. Understanding that connection, and acting on it, could prevent many cancers before they start.
Source: Florida Atlantic University