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Alcohol-fueled cancer deaths rise sharply in US over 30 years: The science behind it

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Cancer deaths linked to alcohol are on the rise even as the overall cancer deaths in the United States have significantly declined over the past three decades.

A new research has found that annual alcohol-related cancer deaths have nearly doubled since 1990, climbing from just under 12,000 to more than 23,000 by 2021. The study discovered the sharpest increase among men aged 55 and older. The findings will be presented at the upcoming American Society of Clinical Oncology (ASCO) annual meeting in Chicago.

Cancer deaths in the US have dropped by approximately 35% during the same time frame, according to the American Cancer Society.

“This is death as opposed to getting a disease. We can treat a lot of cancers, and we’re getting better at that, but this is really driving home the point that people are dying from cancer due to alcohol,” Jane Figueiredo, a professor of medicine at the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center, who was not involved with the research told NBC News.

A few months back, the US Surgeon General, issued an advisory warning that even small amounts of alcohol can cause cancer and called for cancer warning labels on alcohol bottles.
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Alcohol use is a preventable cause of cancer in the United States, contributing to nearly 100,000 cancer cases and about 20,000 cancer deaths each year, mentioned the advisory.

The study took into account seven alcohol-related cancers - breast, liver, colorectal, throat, voice box, mouth and esophageal. While alcohol isn’t linked with every case of these cancers, it's still a major driving factor. According to WHO, there’s no safe amount of alcohol consumption.

Alcohol is a carcinogen, but people don't think of it as one, and consider it less harmful than tobacco.

However, alcohol can breaks down into a carcinogen called acetaldehyde, also found in tobacco smoke. Alcohol also damages DNA and could ease entry of carcinogens into the mouth and throat.

How does alcohol cause cancer?
Alcohol breaks down into acetaldehyde in the body, a metabolite that causes cancer by binding to DNA and damaging it. When DNA is damaged, a cell can begin to grow uncontrollably and create a cancerous tumor.

Alcohol generates reactive oxygen species, which increase inflammation and can damage DNA, proteins, and lipids in the body through oxidation.

Alcohol can alter hormone levels including estrogen which can lead to breast cancer development.

Carcinogens from other sources, especially particles of tobacco smoke can dissolve in alcohol, making it easier for them to be absorbed into the body, increasing the risk for mouth and throat cancers.

Between 1991 and 2021, alcohol-related cancer deaths rose from 2.5% to 4.2% in men and from 1.46% to 1.85% in women. Deaths increased by 56% in men and nearly 8% in women.

“It was not surprising that it was higher in men, but it was certainly surprising how much higher it was in men versus women,” said study co-leader Dr. Chinmay Jani, chief fellow of hematology and oncology at the University of Miami’s Sylvester Comprehensive Cancer Center.
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Alcohol-related cancer deaths rose in men across 47 states and in women across 16 states, with New Mexico showing the steepest increases—nearly 60% for men and 18% for women. Oklahoma and Tennessee followed closely behind.

Conversely, the largest declines in male deaths were seen in Washington D.C. and New York, while Massachusetts and New York led the drop for women. Utah continued to report the lowest rates nationwide.

Most deaths occurred in individuals aged 55 and older, with alcohol-related cancer deaths in men in this age group increasing by over 1% annually from 2007 to 2021.

“The carcinogenic effect probably isn’t affecting you right away in your younger age, but as you continue to drink as you age, this carcinogen has an accumulative effect on the body,” Jani said.
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