U.S. Surgeon General Vivek Murthy calls for update to alcohol warning labels to include cancer risk

Alcohol is the leading preventable cause of at least seven cancers, and health warning labels on beverages containing alcohol should be updated to highlight that risk, U.S. Surgeon General Dr. Vivek Murthy said Friday.

In an advisory, Murthy said the direct link between alcohol consumption and cancer risk is well-established for those cancers, which include breast, colorectal, esophagus, liver, mouth, throat and voice box — with 16.4% of total breast cancer cases attributable to drinking.

The report states that alcohol consumption, after tobacco and obesity, is the third leading preventable cause of overall cancer in the nation. The label statement can only be changed through a vote by Congress, Murthy said.

Alcohol contributes to nearly 100,000 cancer cases and about 20,000 cancer deaths each year in the nation, according to the advisory. Murthy pointed out that is greater than the 13,500 alcohol-associated traffic crash fatalities recorded annually in the United States.

In New York State, about 3.2% or 1,082 cancer deaths every year are linked to alcohol consumption, according to the Centers for Disease Control and Prevention. Statistics from the state Health Department show that the five-year average incidence rates of alcohol-related cancer in Suffolk County is 138.7 per 100,000 persons and 136.8 per 100,000 persons in Nassau County for 2016-2020.

The Beer Institute, which represents the beer industry, did not comment directly on the plan to update warning labels but issued a statement saying the industry "has been a champion of responsible consumption for decades."

"We encourage adults of legal drinking age to make choices that best fit their personal circumstances, and if they choose to drink, to consume alcohol beverages in moderation," the statement read.

The U.S. Surgeon General's report is vital because it points out the connection between cancer and alcohol that has not been emphasized enough, said Dr. Brittney S. Zimmerman, breast medical oncologist at Northwell Health Cancer Institute.

"The association between alcohol and liver disease and liver cancer is more obvious and people understand that," she said. "But I don't think that the link between alcohol and these other cancers, including female breast cancer, are really well known to the public at all ... I think that labeling would be an effective strategy to help increase awareness."

Zimmerman said previous studies showing a moderate amount of alcohol consumption was associated with a lower risk of mortality may need further investigation.

"Some of that evidence has probably become outdated," she said. "And some of that data may not have been obtained rigorously enough to meet current standards. We are still learning about the true impact between alcohol and cancer risk."

Along with casting further doubt on the belief that moderate alcohol consumption protects against cardiovascular disease, the advisory pointed out that more data shows even drinking lower amounts of alcohol has some risks, said Dr. Paolo Boffetta, associate director for Population Sciences at the Stony Brook Cancer Center. 

"Typically, the recommendation was not to go above one drink per day for women and two drinks per day for men," he said. "Now they are saying two or three drinks per week can possibly bring some risks for cancer."

Boffetta said while research on the links between cancer and tobacco and obesity have been well established, the alcohol-cancer connection has received less attention over the years.

"I hope this new document will raise awareness in the research community," he said. "There are many things we still need to study better in terms of alcohol and cancer."

The report states that updated warning labels could increase awareness and maybe convince some people to change their drinking behavior. While 72% of U.S. adults reported consuming one or more drinks per week, according to data from 2019-2020, less than half said they were aware of the link between alcohol consumption and cancer risk, according to the advisory. 

There has to be education of both the public and members of the health care community, said Dr. Mark Solomon, medical director of the Chemical Dependency Rehabilitation Program at St. Charles Hospital in Port Jefferson.

"I think there are physicians out there and even cardiologists who are saying it's OK to have a little and that it's good for you," said Solomon. "That's antiquated thinking ... we just can't live under what we were told in the past because evidence comes to play, studies have been done."

Solomon said he would like to see public service ads similar to the hard-hitting messages about smoking and cancer because not enough people know about the risks.

"Because it's not an immediate effect, because it doesn't happen right away, they don't realize that the cumulative effect that this has on the body until it's too late," he said.

Currently, labels on alcoholic beverages warn women that drinking during pregnancy increases the risk of birth defects. They also point out that consuming alcoholic beverages "impairs your ability to drive a car or operate machinery and may cause health problems."