HHS review suggests alcohol use increases the risk for death, cancer

Key takeaways:

• An HHS review found increased mortality risk starting at low levels of alcohol consumption.
• The report also advised that alcohol intake also increased the risk for death from several cancers.

The HHS’ Interagency Coordinating Committee on the Prevention of Underage Drinking, or ICCPUD, published its draft report on associations between health and alcohol intake, finding that even moderate alcohol intake raises the risk for death.

The data contrast those reported in the recent review from the National Academies of Sciences, Engineering, and Medicine (NASEM), which showed that moderate alcohol drinkers may have a lower risk for death from all causes and CVD.

The ICCPUD’s review, like NASEM’s report, does not include recommendations on alcohol consumption but is instead intended “to help inform HHS and [the U.S. Department of Agriculture] in developing guidance on alcoholic beverages and health” for the 2025-2030 Dietary Guidelines for Americans, a press release from the Office of Disease Prevention and Health Promotion said.

The findings also come after U.S. Surgeon General Vivek Murthy, MD, MBA, issued an advisory that included several recommendations for limiting the effects of alcohol use on cancer mortality, such as updated warning labels.

Alcohol intake raises risk for death

Most of the evidence on mortality, morbidity and alcohol intake in adults and youth assessed by ICCPUD came from meta-analyses and systematic reviews of observational cohort studies. Meanwhile, the analysis did not include data from quasiexperimental or randomized trials.

The six-member committee found that the risk for death from alcohol use starts at low levels of average use, whereas mortality risk grows progressively greater with higher levels of alcohol intake.

In the U.S., the risk for dying from alcohol use among men and women is:

• one in 1,000 if they consume over seven drinks a week; and
• one in 100 if they consume over nine drinks a week.

The risk for alcohol-attributable death also varied by consumption level between the ages of 15 to 20 years. The risks for death among boys and men between those ages ranged between 0.07 (95% CI, 0.05-0.08) per 1,000 for those who consume one drink a week to 1.76 (95% CI, 1.42-2.28) per 1,000 for those who consume three drinks a day or 21 drinks a week.

Among girls and women, the analysis showed a risk for alcohol-attributable death of 0.03 (95% CI, 0.02-0.04) per 1,000 for those who consume one drink a week to 0.75 (95% CI, 0.57-1.06) per 1,000 for those who consume three drinks a day.

Most of these alcohol-attributable deaths are the result of road traffic crashes, unintentional injuries or intentional injuries and represent a substantial proportion of all deaths among those aged 15 to 20 years, the researchers noted.

Cancer, diabetes also tied to alcohol

The report also concluded that alcohol use is tied to a greater risk for death from colorectal, female breast, liver, oral cavity, pharynx, larynx and esophagus cancer, with the risk for these deaths beginning at any alcohol use and increasing with higher levels of use.

Alcohol-attributable deaths from cancer

Men and women who consumed one drink a day had a greater risk for liver cirrhosis, esophageal cancer, injuries and oral cancer but a lower risk for ischemic stroke, whereas women who consumed one drink a day also had a higher risk for liver cancer and diabetes mellitus.

Some of these findings, specifically the lower risk for ischemic stroke and greater risk for breast and colorectal cancer, aligned with those of the NASEM’s report.

Risks for outcomes started at one drink per occasion — defined as how much alcohol is consumed within a short time period rather than how much is consumed on average — and showed particular significance among women who consumed more than three drinks per occasion and men who consumed more than four.

The risks associated with alcohol consumption “are affected by numerous factors, including smoking, diet, physical activity, obesity, hepatitis infection and genetics,” the committee members wrote.

Comments on the draft report can be submitted here through Feb. 14.

References:

• Draft report: Scientific findings of the alcohol intake & health study for public comment. Available at: https://nap.nationalacademies.org/catalog/28582/review-of-evidence-on-alcohol-and-health. Accessed Jan. 22, 2025.
• HHS committee publishes findings on alcohol and health. Available at: https://odphp.health.gov/news/202501/hhs-committee-publishes-findings-alcohol-and-health. Published Jan. 14, 2025. Accessed Jan. 22, 2025.