Author: Linda Carroll

Despite conclusive research showing that all alcoholic beverages, including wine, increase the risk of many types of cancer, a survey of nearly 4,000 U.S. adults found that less than a third knew that alcohol consumption was a risk factor for cancer. Even fewer, just over 20%, realized that drinking wine could raise the risk of cancer, according to the report published Thursday in Cancer Epidemiology, Biomarkers and Prevention.

The new findings show that “most Americans don’t know that alcohol is a leading modifiable risk factor for cancer,” Andrew Seidenberg, Ph.D., who was a cancer prevention fellow at the National Cancer Institute when the research was conducted, tells

“All alcoholic beverages increase cancer risk, but there are variations in awareness by the beverage type, with wine being the lowest. In fact, 10% of U.S. adults incorrectly believe that wine decreases cancer risk.”

Unfortunately, the link hasn’t gotten much attention in the media, says Seidenberg, who is now research director at Truth Initiative, a nonprofit public health organization.

A 2021 study found that alcohol consumption accounted for 75,199 cancer cases and 18,947 cancer deaths annually in the U.S. Other research has linked alcohol consumption to several types of cancer, including cancers of the breast, mouth and colon.

Most Americans drink, and Seidenberg wonders if some would choose to cut back if they understood the link with cancer.

In 2019, 54.9% (59.1% of men, 51% of women) reported drinking in the past month, with 25.8% (29.7% of men group and 22.2% of women) reporting that they engaged in binge drinking in the past month, according to the National Institute on Alcohol Abuse and Alcoholism.

COVID-19 may have pushed those numbers up. Alcohol consumption rose during the pandemic, with American adults drinking 14% more often in the spring of 2020 versus the same time the previous year, according to a study published in JAMA Network Open in September of 2020.

To take a closer look at Americans’ awareness of the link between alcohol and cancer, Seidenberg and his colleagues turned to data from the 2020 Health Information National Trends Survey 5 Cycle 4, which included responses from 3,865 adults. The respondents were asked about wine, beer and liquor: “In your opinion how much does drinking the following types of alcohol affect the risk of getting cancer?”

Overall, 31.2% of those taking the survey said they thought liquor was linked with a heightened risk of cancer, but just 20.3% said they thought wine was linked to an increased cancer risk, and 10.3% said they thought drinking wine reduced their risk of cancer.

“Research is definitely needed to identify messages and messaging strategies that can increase awareness,” Seidenberg says. “Interventions that could help increase awareness of the alcohol-cancer link include mass media campaigns, cancer warning labels and patient-provider communications.”

It’s surprising that so few people are aware of the relationship between alcohol and cancer risk, Dr. Walter Willett, professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health, tells

About 50 years ago, the first connection, between oral cancer and heavy drinking, was discovered, Willett says. “Since that time, we’ve learned that even very modest amounts of alcohol increase the risk for breast cancer. Even half a drink a day or three to four a week can increase breast cancer risk by a small amount. What is surprising is how sensitive breast tissue is to alcohol.”

While the rise in the risk of breast cancer is not as large as that with smoking, it’s still significant, Willet said. “One way of looking at it is it can negate the benefit of mammography.”

Katherine Keyes, Ph.D., professor of epidemiology at the Columbia University Mailman School of Public Health, suspects that part of the explanation for the lack of awareness could be the findings of earlier observational studies that suggested people who drank moderately had a lower risk of premature death. Those studies were flawed, said Keyes.

“When researchers used more rigorous study designs, it became clear that no amount of alcohol helps you live longer,” Keyes said. “There is no safe amount.”

One of the issues with the older studies is that researchers asked only if people were currently drinking. Many of those who were listed as abstainers “had to stop drinking because of health problems,” Keyes says. Moreover, it turns out that moderate drinkers often had a lot of healthy lifestyle factors, she adds.

Keyes suspects the link between alcohol and cancer isn’t getting through to the public because “the beverage industry is out there shaping the message. When you compare industry resources to those of public health, we are greatly outspent.”

Getting the message out there is especially important in a time when alcohol consumption is going up, especially among women, Keyes said. “Studies have shown the biggest increases are among women aged 30 to 45,” she added. “We need to target messaging to the groups who are drinking more and more.”

Unfortunately, the message that moderate drinking could be good for you “really got out there,” said Christina Mair, Ph.D., associate professor in the University of Pittsburgh School of Public Health’s department of behavioral and community health sciences.

“This is not a case where the medical literature needs to catch up, it’s more of a messaging issue,” Mair says. “It’s a women’s health issue, and we need to do a better job talking about the fact that there is no health benefit, particularly around cardiovascular disease and cancer.”

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