U.S. Surgeon General calls for new label on drinks to warn Americans of alcohol’s cancer risk

WASHINGTON — Alcohol is a leading cause of cancer, a risk that should be clearly labeled on drinks Americans consume, U.S. Surgeon General Vivek Murthy proposed Friday.

Murthy's advisory comes as research and evidence mounts about the bad effects that alcohol has on human health — including a warning last year from the Iowa Cancer Registry as the state posted the nation’s second-highest rate of cancer — but his proposal for a label would require a rare approval from the U.S. Congress.

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Americans should be better informed about the link between alcohol and cancer, Murthy argued in his advisory, noting alcohol consumption is to blame for nearly 1 million preventable cancer cases in the United States over the last decade.

While Americans are well aware that radiation, tobacco, asbestos and obesity lead to cancer, fewer than half those who responded to a survey know that alcohol could also, according to a 2019 American Institute for Cancer Research survey.

About 20,000 people die every year from those alcohol-related cancer cases, according to his advisory.

Iowa has the nation’s second-highest rate of cancer — behind Kentucky — and the fastest growing rate of new cancers, with another 21,000 estimated in 2024, according to the latest Iowa Cancer Registry’s “Cancer in Iowa” report.

And while a confluence of factors are believed to be behind Iowa’s rising cancer rates — making it the only state in the nation reporting a significant increase in incidence from 2015 to 2019 — one piece of the puzzle is Iowa’s high rates of alcohol use.

Defining binge drinking as five or more drinks on one occasion for men and four or more drinks for women, more than one-fifth — or 22 percent — of adults in Iowa reported binge drinking in 2022, well above the national average of 17 percent.

The 2024 "Cancer in Iowa" report noted that Iowans’ high alcohol consumption — in volume and frequency — puts its residents at greater risk for cancer. It noted the state has the fourth-highest incidence of alcohol-related cancers in the United States and has the highest rate in the Midwest.

“While drinking any alcohol can increase one’s risk of cancer, heavy drinking and binge drinking pose the greatest risk,” Mary Charlton, professor of epidemiology in the University of Iowa College of Public Health and the Cancer in Iowa report’s co-author, said at the time.

The Iowa report, however, did not go as far as recommending that labels on alcoholic beverages be changed — as did the surgeon general urged Friday.

Alcohol can trigger cancer by disrupting metabolism and damaging DNA, researchers have found, including when it alters breast tissue by increasing estrogen. Alcohol can also alter cells in the mouth and throat, making it easier to absorb carcinogens such as tobacco smoke.

Bottles of beer, wine and liquor already carry warning labels that say pregnant women should not drink and that alcohol consumption can impair someone's ability to drive a car. But Murthy's proposed label would go further, raising awareness about the risk for cancer, too.

“It’s pretty crazy that there’s a lot more information on a can of peas than on a bottle of whiskey,” said Dr. Timothy Naimi, who directs the Canadian Institute for Substance Use Research at the University of Victoria in British Columbia. “Consumers have the right to basic information about health risks, serving size and drinks per container.”

Consuming alcohol raises the risk of developing at least seven types of cancer diseases, including liver, breast and throat cancer, research has found. Murthy's advisory also notes that as a person's alcohol consumption goes up, so does the risk for developing those illnesses.

“For individuals, be aware that cancer risk increases as you drink more alcohol,” Murthy wrote Friday on the social media platform X. “As you consider whether or how much to drink, keep in mind that less is better when it comes to cancer risk.”

With Republicans taking control of Congress and only a few weeks left until a new presidential administration takes over, it’s unclear how far Murthy’s recommendations will go.

President-elect Donald Trump, who will be inaugurated Jan. 20, has announced Janette Nesheiwat, a family and emergency medicine physician and onetime Fox News contributor, as his pick for surgeon general. A spokeswoman for the Trump transition team did not immediately return a request for comment to a reporter for the Washington Post.

Trump has said he does not drink, citing his alcoholic brother who died young. Nesheiwat has warned of the health dangers of alcohol generally in her role as a medical commentator.

But even with the surgeon general's advisory and new research that shows the dangers of drinking, it's unlikely Congress would act swiftly to enact a new warning on alcohol products.

It's been nearly four decades since Congress approved the first government warning label on alcohol, the one that says pregnant women shouldn't drink and warns about the dangers of driving while drinking. No updates have been made since then.

Before that, Congress approved a label on cigarettes cautioning users that smoking is hazardous to health, a move that is credited with helping America substantially reduce its bad habit.

Any effort to add a cancer warning label to alcohol would face significant push back from a well-funded and powerful beverage industry, which spends nearly $30 million every year lobbying Congress.

The surgeon general’s advisory comes as the government is in the process of updating dietary guidelines, including those around alcohol, that will form the cornerstone of federal food programs and policy. The updated guidelines are expected later this year.

The current guidelines recommend women have one drink or fewer per day while men should stick to two or fewer.

The Washington Post and Vanessa Miller of The Gazette contributed to this report.