Summary:
Alcohol is a preventable contributor to cancer risk and has been established as a carcinogen with clear links to several cancer types. Risk increases as alcohol intake rises and is evident even at lower levels of consumption. Despite this, alcohol use remains common among adults in the United States, ranging from infrequent drinking to alcohol use disorder. Cancer risk associated with alcohol is not evenly distributed across the population. While people with higher socioeconomic status may consume similar or greater amounts of alcohol, those with lower socioeconomic status experience greater harm due to co-existing health conditions, reduced access to healthcare, and social disadvantage. This study is a systematic review which examined associations between different levels of alcohol consumption and cancer risk in U.S. adults. It also explored the role of co-existing conditions such as obesity, smoking, diabetes, and liver disease, as well as social and demographic factors that may amplify cancer risk. Sixty-two studies met the inclusion criteria. Alcohol consumption was consistently associated with increased risk of multiple cancers, most commonly breast, colorectal, and liver cancer. Age and race or ethnicity were the most frequently reported individual risk factors. Several studies also identified obesity, alcoholic liver disease, and diabetes as conditions that may further increase cancer risk among people who consume alcohol. A dose-dependent relationship was also observed, indicating that cancer risk rises with increasing alcohol intake rather than being limited to heavy or long-term use. Overall, this study demonstrates that alcohol consumption, particularly at higher frequency or volume, is associated with increased risk of several major cancers. The findings support the need for prevention strategies that address alcohol use across the full range of consumption levels and account for social and health inequities that place certain populations at greater risk.
Abstract:
Background: The frequency and quantity of alcohol consumption, even at moderate levels, influence both cancer incidence and outcomes. This systematic review examines the relationship between varying levels of alcohol consumption and the risk of developing cancer in U.S. adults. It also explores the comorbid conditions that may increase long-term cancer risk among alcohol users and identifies the social and demographic factors that place certain population groups at heightened risk. Methods: The review followed the Arksey & O’Malley Framework and the Joanna Briggs Institute (JBI) recommendations for the extraction, analysis, and presentation of results in systematic reviews. [This framework consists of five steps: (1) identify research questions; (2) search for relevant studies; (3) select studies relevant to the research questions; (4) chart the data; and (5) collate, summarize, and report results. Results: A total of 62 studies were retained for analysis following title, abstract, and full text screening. Race/ethnicity (n = 46/62) and age (n = 42/62) were the most frequently mentioned individual risk factors. Across the 62 studies reviewed, alcohol consumption was consistently identified as a risk factor for several types of cancer, including breast (n = 23/62), colorectal (n = 13/62), and liver (n = 10/62), among others. Other alcohol-associated comorbidities reported include obesity (n = 8/62), alcoholic liver disease (n = 5/62), and diabetes (n = 4/62). Conclusion: Alcohol intake, particularly at higher frequency or greater quantity, was consistently associated with elevated risk for multiple cancers, most notably colorectal, breast, and liver. Dose-response relationships were a common finding, underscoring that risk is not limited to heavy or chronic use.
Article Publication Date: 13/11/2025
DOI: 10.1016/j.canep.2025.102956
