Alcohol use is the third leading preventable cause of cancer in the US after tobacco and obesity, according to a new advisory by the US surgeon general.

Released on Friday, the advisory revealed that alcohol use contributes to nearly 100,000 cancer cases and about 20,000 cancer deaths each year. It also found that alcohol-related cancer deaths shorten the lives of those who die by an average of 15 years.

According to the advisory, the largest burden of alcohol-related cancer in the US is for breast cancer in women, with an estimated 44,180 cases in 2019, marking 16.4% of the approximately 270,000 total breast cancer cases for women.

Among women, breast cancer makes up approximately 60% of alcohol-related cancer deaths. Meanwhile, liver cancer, at approximately 33%, and colorectal cancer, at approximately 21%, make up the majority of alcohol-related cancer deaths in men.

Overall, consuming alcohol increases the risk of developing at least seven types of cancer. In addition to colorectal and breast cancers, alcohol consumption increases the risk of mouth, throat, esophagus, voice box and liver cancers.

The advisory also found that about 83% of the estimated 20,000 alcohol-related cancer deaths in the US annually occur among people who drink at levels above the federally recommended limits of two drinks daily for men and one drink daily for women. It also stated that the remaining 17% of the estimated 20,000 annual alcohol-related cancer deaths occur at levels within the recommended limits.

The advisory listed four ways that alcohol can cause cancer including alcohol’s breakdown into acetaldehyde in the body, which damages DNA in various ways, thereby increasing the risk of cancer. Alcohol can also induce oxidative stress, in turn increasing cancer risk by damaging DNA, proteins and cells, and increasing inflammation. The third way is alcohol’s ability to alter levels of multiple hormones including estrogen, which can increase breast cancer risk. Alcohol consumption can also lead to greater absorption of carcinogens.

Despite the clear links between alcohol consumption and cancer risk, less than half of Americans are actually aware of the risk. According to a 2019 survey cited in the advisory, 45% of Americans recognized alcohol use as a risk factor for cancer compared with 91% of Americans who recognized the risk of radiation exposure, 89% for tobacco use, 81% for asbestos exposure and 53% for obesity.

Friday’s advisory is not the first report to highlight the link between alcohol consumption and cancer risk.

In August, a similar report by the Autonomous University of Madrid found that harms related to drinking may be greater for people in worse health. According to researchers, high-risk drinking posed a higher risk of dying from cancer or cardiovascular disease.

Moreover, a report by the American Association of Cancer Research published in September found that heavy alcohol consumption increased the risk of six types of malignancies. Those include esophageal squamous cell carcinoma, as well as certain types of head, neck, breast, colorectal, liver and stomach cancers, the New York Times reported, citing the report.

the Guardian