Alcohol and Cancer: What You Need to Know
Find out if it's still OK to drink.
The U.S. Surgeon General (SG) recently released an Advisory linking alcohol intake to cancers of the breast (in women), mouth, throat, esophagus, larynx, liver, and colon/rectum. While the connection between alcohol and cancer is news to a lot of people, evidence of the association has been brewing for decades.
Let’s get into it.
How Alcohol Affects Your Body: The Cancer Connection
Alcohol increases cancer risk by harming DNA in several ways. DNA is the compound in cells that directs their function and replication.
Ethanol is the pure alcohol present in alcohol. The body breaks down ethanol to acetaldehyde, which is damaging to DNA. Alcohol also causes inflammation that impairs DNA, proteins, and fats in the body.
Alcohol interferes with the metabolism of several nutrients, including the B vitamin folate, which is vital to DNA production. And, alcohol can increase estrogen levels, promoting the growth and division of breast cells in pre- and post-menopausal women. In addition, alcohol is a vehicle for carcinogens from other sources, such as tobacco smoke, which are more easily absorbed by the body in the presence of alcohol.
The body can only repair so much DNA, and when cells are repeatedly exposed to alcohol, mutations in cell replication occur and cancer forms.
Is Any Amount of Alcohol Safe?
Not everyone who drinks gets cancer, which begs the question: at what level does alcohol become problematic? Though there are guidelines for moderate drinking, evidence suggests that they may not protect against certain cancers, including breast cancer.
Before we talk about breast cancer, let’s review what experts consider moderate drinking.
The 2020-2025 Dietary Guidelines for Americans (DGA) defines moderate drinking for women as one “standard drink” or less daily. The U.S. definition of a standard drink contains about 14 grams of alcohol. Each of the examples of a standard drink pictured below have the same alcohol content.
Source: National Institute of Alcohol and Alcohol Abuse
The total amount of alcohol consumed is related to cancer risk which is why it’s important to consider how much alcohol you drink and not just the number of drinks you have.
A study of beverages served at restaurants found that the average wine pour had 43% more alcohol than a standard drink, the average draught beer was 22% greater than the standard, and that drinks with distilled spirits, like gin and tonic, Cosmopolitan, or rum and Coke, were 42% higher in alcohol than the standard drink definition.
It's easy to overdo it at home, too, especially if you’re using a large wine glass and pouring more into it before you’ve finished what’s in your glass. Research suggests that the alcohol portions poured at home are often larger than standard servings.
Enjoying an occasional drink will not give you cancer. When it comes to alcohol, risk is related to how much you drink on a regular basis and for how long. Yet, it’s important to note that about 17% of all alcohol-related deaths each year in the U.S. occur at alcohol intake levels that are within the DGA limits, according to the SG’s report.
“Researchers have not been able to find a level of alcohol consumption that could be labeled as “safe” with no increase in cancer risk,” says Karen Collins, MS, RDN, nutrition advisor to the American Institute for Cancer Research.
The Role of Alcohol in Breast Cancer
Alcohol affects the risk for different types of cancer differently. In the case of breast cancer, the risk rises when women drink even less alcohol than the suggested limit.
According to the SG, breast cancer risk may start increasing around one or fewer standard drinks per day, and it increases as alcohol intake increases. Research published in Alcohol Clinical & Experimental Research in 2024 that pooled the results of nine studies of alcohol and breast cancer suggests the same.
The authors concluded that alcohol consumption ups breast cancer risk in pre- and postmenopausal women who consume one drink daily. However, it’s important to consider that the definition of a drink in the study was 10 grams of alcohol, not the 14 grams in a standard U.S. drink. That means that the risk of breast cancer increased with about 3/4 of one standard U.S. drink, which is about 3 1/2 ounces of wine daily.
How to Reduce Cancer Risk
Your risk for cancer is complex and typically can’t be blamed on any single factor. Cancer risk is determined by genetics, the environment, and myriad other factors, including health habits.
“Most diet and other factors come together to create an overall lifestyle that increases or decreases cancer risk,” Collins says. “Each factor on its own might seem to be a small relative risk, but that’s how choices add up to influence someone’s overall risk.”
In addition to limiting or avoiding alcohol, you can also help reduce cancer risk by following a balanced eating plan rich in plant foods and low in red and processed meats and added sugars, maintaining a healthy weight, staying physically active, and avoiding cigarettes and cigarette smoke.
Though the risks presented by alcohol in the SG’s report and in other research do not account for a person’s individual risk for developing cancer, alcohol should be top of mind as a lifestyle factor. The American Institute for Cancer Research and American Cancer Society guidelines both say that it’s best not to drink alcohol when trying to reduce cancer risk.
That doesn’t mean you must entirely give up your favorite wine, beer, or cocktail. Of course, women should avoid alcohol if they are pregnant, have certain medical conditions, are taking medications that interact with alcohol, if they’re recovering from an alcohol use disorder, or can’t control the amount they drink.
“As with all diet and lifestyle choices that can improve health and reduce risk of chronic disease, alcohol use is a personal decision,” says Collins. “Each step in decreasing alcohol consumption is associated with some decrease in cancer risk.”
What do you think? Let me know!
.