Approved by the Cancer.Net Editorial Board, 07/2022

Alcohol use has been consistently linked to an increased risk of cancer. The type of alcohol — wine, beer, or liquor — does not change this risk.

Like tobacco use, drinking alcohol is a cancer risk that you can control. Researchers call this a "modifiable risk factor." This means that you can change your behavior to reduce your risk.

Drinking alcohol can increase your chance of developing these types of cancers:

The risk of developing these cancers is higher the more a person drinks, particularly over time. The risk is higher for cancers of the larynx, esophageal, and oral cavity. This is because these tissues come into direct contact with alcohol when a person drinks it.

How does alcohol increase cancer risk?

Researchers are still studying how and why alcohol increases cancer risk. They think that alcohol may contribute to cancer risk in these ways:

Ethanol. Ethanol is the form of alcohol in beer, wine, and spirits. When the body metabolizes, or breaks down, ethanol, it forms acetaldehyde. Acetaldehyde may be a carcinogen, meaning it may be known to cause cancer in humans. It can damage DNA and proteins.

Oxidative stress. "Oxidative stress" happens when there are too many free radicals and not enough antioxidants in your body. Alcohol can produce a molecule called a "reactive oxygen species" or ROS, which is considered a free radical.

By irritating healthy cells. Alcohol is an irritant. When a person drinks alcohol, it can damage healthy cells in the mouth and throat. As those cell repair themselves, there may be DNA changes that can lead to cancer.

Increasing estrogen. Too much estrogen has been linked to an increased risk of breast cancer.

Problems breaking down and processing important nutrients. Drinking alcohol may weaken the body's ability to process and absorb important nutrients. These include:

  • Vitamin A

  • Vitamin C

  • Vitamin D

  • Vitamin E

  • Folate

  • Carotenoids

Recommendations for alcohol use

There is no proven way to completely prevent cancer. But there are steps you can take to lower your alcohol-related risk of cancer.

Avoid drinking alcohol. Recent research has shown that any amount of alcohol can increase your risks for certain health conditions, including cancer.

Limit the number of alcoholic beverages you drink. If you continue to drink alcohol, it is important to limit how much alcohol you drink. For women, limit alcohol to 1 drink or less a day. For men, limit alcohol to 2 drinks a day or less. A drink is defined as:

  • 12 ounces (oz) or 341 milliliters (ml) of beer

  • 5 oz or 142 ml of wine

  • 1.5 oz or 43 ml of 80-proof liquor

This is considered moderate drinking. You can view a table on the National Institute of Health's website that summarizes what counts as a standard drink.

The risk of developing the types of cancer listed above increases when you drink more alcohol. But there is still some increased risk of developing cancer even with light drinking.

Talk with your doctor about your risk for the cancers mentioned above. You and your doctor may decide that you should limit your drinking even more.

Do not binge drink or drink heavily. For women, binge drinking is considered having 4 or more drinks in a short period. For men, it means having 5 or more drinks. Binge drinking may increase your risk for certain cancers, even if you do not binge drink often.

Do not make an exception for red wine. There is no clear evidence that drinking red wine helps prevent cancer. Because there is clear evidence that alcohol use and binge drinking can lead to cancer, the current recommended limits also apply to red wine.

Avoid using both alcohol and tobacco products. Combining alcohol and tobacco products can further increase your risk of developing certain cancers. These include cancers of the oral cavity, pharynx, larynx, and esophagus.

Add folate to your diet. Eating enough folate may help protect against the risk of some cancers linked with alcohol, such as breast cancer. Folate is found in leafy green vegetables, fruit, and dried beans and peas.

Talk to your doctor if you are taking hormone therapy for menopause. When combined with alcohol, this type of medication can increase the risk of some cancers, like breast cancer. Your doctor may suggest you reduce your drinking while taking this kind of medication.

Ask your doctor if you need to avoid alcohol during cancer treatment. Some people may need to avoid alcohol completely during cancer treatment. Alcohol can interact with your medication and make side effects worse. For example, alcohol may irritate or worsen treatment-related mouth sores or dry mouth. It can also increase the risks of side effects from treatment by causing dehydration or nutrient loss.

Alcohol and the risk of cancer recurrence

If you are a cancer survivor, you may worry about drinking alcohol and your risk of cancer recurrence. Recurrence is when cancer comes back after treatment.

More research is needed to understand how alcohol affects cancer recurrence. Alcohol use, survival rates, and the risk of recurrence have been studied in breast cancer survivors. Results from these studies have been mixed. Some studies showed that alcohol drinking is not associated with lower survival rates. Other research shows moderate and heavy alcohol use can increase the risk of recurrence and lower survival rates for certain breast cancer survivors.

Studies also show that head and neck cancer survivors who continue moderate to heavy alcohol use are at an increased risk of recurrence, may have lower survival rates, and have a higher rate of second cancers.

If you are a cancer survivor, talk with your doctor about how much alcohol you drink and the effect it could have on your long-term health.

The information in this article is based on Alcohol and Cancer: A Statement of the American Society of Clinical Oncology, found on ASCO’s website.

Resources to help you change your drinking habits

Whether you want to reduce the amount of alcohol you drink or quit altogether, it can be a challenge. This can be true even if you only drink a light or moderate amount of alcohol.

For many people, alcohol is a part of their daily routine, an important part of celebrations and social events, and a way to manage stress and anxiety. It can feel overwhelming to make a change to your drinking habits. There are free resources you can turn to for help. Please note that the links in this section will take you to another website/organization that is not affiliated with Cancer.Net or the American Society of Clinical Oncology.

Better Health and Drink Free Days App. The National Health Service of the UK has created a resource and mobile app to help you cut down on your drinking. You can learn more about practical ways and reasons to reduce the amount your drinking and download the mobile app to help track your drink free days.

Drinkaware. The MyDrinkaware app can help you track your drinking, test your risk level, and set goals so you can change your drinking habits over time.

Moderation Management. This nonprofit offers a variety of resources for people who would like to cut back or quit drinking.

Rethinking Drinking from the U.S. National Institutes of Health (NIH). This resource from the U.S. government includes information about how to decide if you need to cut back or quit drinking, how to make the change, and where to find support.

Questions to ask the health care team

  • How much alcohol is safe for me to drink?

  • Do my drinking habits put me at an increased risk for cancer?

  • What can I do to lower my risk of cancer?

  • What cancer screening tests do you recommend? How often should I have them?

  • Do you recommend any programs or resources I can use to help me cut back or quit drinking?

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