# Alcohol caused an estimated 741,000 cancers worldwide in 2020

Source: https://onco.cc/key-papers/paper-alcohol-cancer-burden-lancet-oncol-2021/  
OnCo record `paper-alcohol-cancer-burden-lancet-oncol-2021` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Building on the IARC classification of alcohol as a Group 1 carcinogen, this global modelling study attributed 4.1% of all new cancers in 2020 to drinking, three-quarters of them in men and the largest numbers in oesophageal, liver and breast cancer.

## Summary

IARC Monographs volumes 44, 96 and 100E established alcoholic beverages, and the acetaldehyde derived from them, as Group 1 carcinogens with sufficient evidence for cancers of the oral cavity, pharynx, larynx, oesophagus (squamous), liver, colorectum and female breast. Rumgay and colleagues combined per-capita alcohol consumption estimates (with a 10-year lag) and relative risks from meta-analyses with GLOBOCAN 2020 incidence to estimate the attributable burden by country, sex and site.

An estimated 741,300 new cancers (4.1% of all cases) were attributable to alcohol in 2020; 76.7% were in men. Oesophageal (189,700), liver (154,700) and breast (98,300) cancers had the largest numbers. Heavy drinking accounted for most of the burden, but moderate drinking (up to two drinks a day) contributed around 100,000 cases.

The paper drove policy interest in alcohol labelling and pricing, and the 2023 WHO and 2025 US Surgeon General statements on alcohol and cancer.

## Fields

- Kind: Key paper
- Last checked: 2026-09-08
- Journal: Lancet Oncology
- Year: 2021
- DOI: 10.1016/S1470-2045(21)00279-5
- Authors: Rumgay H, Shield K, Charvat H, et al.
- Findings: 741,300 alcohol-attributable new cancers globally in 2020 (95% uncertainty interval 558,500-951,200), 4.1% of all cancers; 76.7% of attributable cases were in men; Largest contributions: oesophagus 189,700; liver 154,700; female breast 98,300; Moderate drinking (less than 20 g/day) accounted for an estimated 103,100 cases (13.9% of the alcohol burden)
- What it means: There is no safe level of alcohol for cancer risk, and the risk is highest for cancers of the mouth, throat, oesophagus, liver, bowel and breast. Public awareness is low; most people do not know alcohol causes breast cancer. Warning labels and minimum pricing are the policy levers being debated.
- Caveats: Modelled estimates depend on consumption data of uneven quality and on relative risks from observational meta-analyses; Unrecorded alcohol consumption is poorly captured in many countries; Does not account for former drinkers or interactions with smoking; Population-level estimates say nothing about individual risk trajectories

## Sources

- DOI: https://doi.org/10.1016/S1470-2045(21)00279-5
- IARC Monographs Volume 100E: https://publications.iarc.who.int/122

## Connected records

- ideas: [Cancer warnings on alcohol labels, evaluated as a natural experiment](https://onco.cc/ideas/idea-prev-alcohol-cancer-warning-labels/), [Community pharmacies as one-stop cancer prevention hubs](https://onco.cc/ideas/idea-prev-pharmacy-prevention-hub/)
- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Head and neck squamous cell carcinoma](https://onco.cc/cancers/head-and-neck/), [Hepatocellular carcinoma](https://onco.cc/cancers/hcc/), [HR-positive / HER2-negative breast cancer](https://onco.cc/cancers/breast-hr-positive/), [Oesophageal cancer](https://onco.cc/cancers/esophageal/)
- fronts: [Prevention & Risk](https://onco.cc/fronts/prevention/)
- institutions: [International Agency for Research on Cancer (IARC / WHO)](https://onco.cc/institutions/iarc/)
- bottlenecks: [Incentives reward me-too drugs and marginal gains](https://onco.cc/bottlenecks/b-incentive-misalignment/), [Misinformation and unproven therapies](https://onco.cc/bottlenecks/b-misinformation/), [Prevention we already have is not deployed](https://onco.cc/bottlenecks/b-prevention-adoption/)
- journals: [The Lancet Oncology](https://onco.cc/journals/lancet-oncology/)

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