A comprehensive review examines how varying levels of alcohol consumption relate to cancer risk in U.S. adults, including associated comorbidities and social determinants of health.

From 62 studies, the review finds strong links between alcohol use and higher risk of breast, colorectal, liver, oral, laryngeal, esophageal, and gastric cancers, with particularly poorer outcomes for alcoholic liver disease-related liver cancer.

Risk factors such as race/ethnicity, age, socioeconomic status, obesity, alcoholic liver disease, and diabetes shape alcohol-related cancer risk and contribute to disparities in outcomes.

Limitations include exclusion of case reports, letters, abstracts, and grey literature, plus potential omissions from reference tracing, which may affect comprehensiveness.

The article provides the study date, authors, DOI, and notes publication in Cancer Epidemiology on November 13, 2025, listing contributing authors and affiliations.

Following American Cancer Society guidelines and embracing broader healthy-lifestyle changes are associated with lower cancer risk and mortality, underscoring moderation plus overall lifestyle improvements.

Policy and prevention implications call for integrated strategies combining lifestyle interventions, policy measures, better access to screening, and early detection to reduce alcohol-associated cancer risk.

Despite alcohol’s Group 1 carcinogen status, public health messaging and labeling often fail to stress cancer risk, revealing a policy gap in consumer communication.

The review includes 45 cohort studies, 13 case-control studies, 2 ecological studies, 1 quasi-experimental study, and 1 cross-sectional study, with participant numbers ranging from tens of thousands to nearly 100 million.

Targeted public health actions are recommended, including tailored messaging, stronger alcohol-related policies, and interventions aimed at high-risk communities to reduce the cancer burden.

There is no universally safe level of alcohol for cancer risk; the findings prompt questions about warnings, routine screening for alcohol use, and better public health information.

Biological mechanisms include acetaldehyde-induced DNA damage, hormonal changes, oxidative stress, immune suppression, and increased carcinogen absorption, interacting with health conditions and genetics to drive cancer development.