The Surgeon General, Vivek Murthy, recently issued his report: “Alcohol Consumption is a Leading Preventable Cause of Cancer” and sent bars, winemakers, and breweries into a panic.

That alcohol increases cancer risk isn’t a new finding, but if you didn’t know, you’re not alone. More than half of consumers didn’t know, according to a study by the American Institute for Cancer Research, referenced in the Surgeon General’s report.

 The “Top Line” of the Surgeon General’s Report on Alcohol & Cancer:

  • Alcohol can cause cancer.
  • The more you drink, the higher your risk.
  • There’s no “safe” level of consumption. 

The Big 7 Cancers

Alcohol isn’t implicated in all cancers, but Murthy’s report accurately says alcohol increases risk for certain cancers [see the National Cancer Institute graphic at right]. A 2023 systematic review and meta-analysis that looked at alcohol and cancer risk concluded:

“…even low levels of alcohol consumption have been found to elevate the risk of esophageal cancer, colorectal cancer, and breast cancer in females, as well as prostate and colorectal cancer in males.”

 

Is All Alcohol Implicated?

Photo: iStock

Yes, because when the body breaks down alcohol from any source, acetaldehyde is produced – mostly in the liver, but some breakdown happens in the mouth and stomach.

Acetaldehyde is a well-known carcinogen, because it plays a role in how DNA gets sufficiently damaged on the journey to producing cancer cells.

There’s “Noise” In Them There Studies…

The studies and systematic reviews “linking” alcohol intake to cancer risk have some confounding variables that weaken the conclusions:

  • Most of the studies referenced, however, were observational and/or cohort studies. That is, they can show an “association” or a “link to” (which media LOVE to use, but these types of studies are not capable of showing a cause-and-effect.
  • Drinking can go along with smoking and tobacco use, a huge cancer risk factor – especially for oral and neck cancers. Not all studies correct for this.
  • There’s positive news: This 2024 National Academies of Science comprehensive report found that “…compared with never consuming alcohol, moderate alcohol consumption is associated with lower all-cause mortality.” 

Putting “deaths” into context, according to the CDC’s 2022 statistics:

Thus, Murthy’s report of 20,000 alcohol-related cancer deaths annually represents just over 3% of those 608,371 cancer deaths.

Adding Warnings On Labels: Would They Reduce Consumption?

Dr. Murthy wants warning labels on all alcoholic beverages.  They’ve been on cigarettes for decades.  Cigarette smoking has declined to historic lows, according to a recent Gallup poll. But was it the warning labels on cigarettes that made the difference?

It may have been cultural shifts that favor a “right to have smoke-free air” over the rights of smokers. Look at the environments where smoking used to be allowed but is now (mostly) banned:

  • Airline flights (and airports!)
  • Hospitals
  • Most municipal buildings & office buildings
  • Restaurants
  • College classrooms (I do remember instructors smoking during class!)

Warning labels were around long before the above smoking bans were.  The culture had to change.  Warning labels on alcoholic beverages may also have to wait for a shift in the culture.

Alcohol &  Culture

Alcoholic drinks are not exactly new.  Almost all cultures have some historic use of either fermented or distilled beverages.  Just a few examples of many:

Mead (fermented from honey). Photo: iStock

  • Rum in South America
  • Wine in Mediterranean countries
  • Beer & ale in the UK
  • Palm wine in West Africa
  • Maize beer in southern Africa
  • Mead in Scandinavia
  • Sake in Japan

Some alcoholic beverages are tied to family traditions, religious rituals or ceremonies, and many families or cultures may resist changing to reduce or eliminate alcohol’s presence in such events.  Also, whereas smoking has second-hand effects on non-smokers, alcohol doesn’t carry the same risk for teetotalers.

The Cut-To-The-Chase-Nutrition “Op-Ed”

Reading Murthy’s report might scare you away from booze forever. Was that the goal, or was it to bring awareness? We’ll probably never know for sure, but it did grab attention.  And let’s face it, the media clamor for headlines like this.

       “Standard drink” sizes Source: CDC

Should you stop drinking?  It’s your call entirely.  That said, if you don’t drink, there’s no reason to start.  If you drink more than is considered a “moderate” amount (1 drink for women, 2 drinks for men), ON ANY ONE DAY, consider trying some of the non-alcohol alternatives.  The no-alcohol versions of beer, wine, and “mocktails” have come a long way. This category of drinks is no longer the flavor wasteland it once was.   

Foodie magazine Bon Appetit even compiled their list of “Nonalcoholic Drinks You Need to Know About Now.  If you don’t want to call attention to drinking lighter, “booze-light”, add a lime wedge to a glass of club soda.  No one will ever know it’s not a vodka tonic.