His recommendation came Friday as part of a new report, Surgeon General’s Advisory on Alcohol and Cancer Risk, which outlines how alcohol consumption is the third leading preventable cause of cancer in the United States, after tobacco and obesity, increasing risk for at least seven types of cancer. 

“Alcohol is a well-established, preventable cause of cancer responsible for about 100,000 cases of cancer and 20,000 cancer deaths annually in the United States—greater than the 13,500 alcohol-associated traffic crash fatalities per year in the U.S.—yet the majority of Americans are unaware of this risk,” said Murthy in a news advisory from the U.S. Department of Health and Human Services. “This Advisory lays out steps we can all take to increase awareness of alcohol’s cancer risk and minimize harm.”

Breast cancer appears to have some of the clearest links, with 16.4% of total cases being attributable to alcohol consumption. But the direct link between alcohol consumption and cancer risk is well-established for at least six other types of cancer including cancers of the colorectum, esophagus, liver, mouth (oral cavity), throat (pharynx), and voice box (larynx)—regardless of the type of alcohol that is consumed. 

For some cancers, including those of the breast, mouth, and throat, evidence shows that the risk of developing cancer may start to increase at one or fewer drinks per day.

That’s alarming, noted Murthy’s report, considering how common alcohol use is among Americans: In 2019-2020, 72% of U.S. adults reported they had one or more drinks per week. But less than half of U.S. adults know about the direct link between alcohol consumption and cancer risk—something first established in the late 1980s, with evidence building over time.

And while supporters of moderate drinking, from alcohol manufacturers to some scientists, believe that a little alcohol each day could reduce cardiovascular disease, newer studies have criticized earlier methodologies and challenge that view.

The American Medical Association, for one, applauded the recommendation, noting in a statement: “For years, the AMA has said that alcohol consumption at any level, not just heavy alcohol use or addictive alcohol use, is a modifiable risk factor for cancer. And yet, despite decades of compelling evidence of this connection, too many in the public remain unaware of alcohol’s risk. Today’s advisory, coupled with a push to update the Surgeon General’s health warning label on alcoholic beverages, will bolster awareness, improve health, and save lives.”

The argument for updated warning labels

Currently in the U.S., every alcoholic beverage sold must carry a label warning about the risks of birth defects as a result of drinking during pregnancy, as well as how drinking alcohol impairs your ability to drive a car and operate machinery, and “may cause health problems.”

But the label has not been updated since its inception in 1988.

Other countries already have cancer-specific warnings, including South Korea and, soon, Ireland, which, as of 2026, will require a label that states, “There is a direct link between alcohol and fatal cancers.” 

According to Murthy’s advisory, health warning labels are “well-established and effective approaches to increasing awareness of health hazards and fostering behavior change,” with “considerable evidence” supporting their use.

In Canada, the advisory points out, a real-world experiment of putting brightly colored warning labels on alcoholic beverage containers noting that alcohol use can cause cancer brought about a 10% increase in knowledge about the associations within just two months. (The experiment was halted prematurely after pushback from alcohol industry lobbying groups.) 

The power to change the label statement lies with Congress. 

Alcohol is already a known carcinogen

More research is needed, Murthy’s advisory notes, to determine how specific drinking patterns may affect cancer risk—as well as how drinking at specific ages and during certain developmental periods may influence the risk of cancer.

But it also points out that the World Health Organization’s International Agency for Research on Cancer already classifies alcohol as a Group 1 carcinogen, the highest level—alongside tobacco, asbestos, and formaldehyde.

Further, the World Cancer Research Fund/American Institute for Cancer Research puts the evidence linking alcohol and cancer into its highest risk category. And the U.S. National Toxicology Program concluded in 2000 that alcoholic beverage consumption is known to be a human carcinogen—something agreed upon by the Centers for Disease Control and Prevention and the National Institutes of Health’s National Cancer Institute.

The way alcohol leads to cancer is by first breaking down in the body into acetaldehyde, a metabolite that causes cancer by binding to DNA and damaging it, prompting a cell to grow uncontrollably and create a cancerous tumor. Alcohol also generates “reactive oxygen species, which increase inflammation and can damage DNA, proteins, and lipids in the body through a process called oxidation,” the report continues.

Alcohol also alters hormone levels—including estrogen, which can play a role in breast cancer—and offers a way for carcinogens from other sources, like particles of tobacco smoke, to dissolve. That makes it easier for the particles to be absorbed into the body, increasing the risk for mouth and throat cancers. 

Other Surgeon General recommendations

In addition to calling for updated warning labels, Murthy calls for a reassessment of the guideline limits for alcohol consumption to account for cancer risk. 

It also advises individuals to be aware of the relationship between alcohol consumption and increased cancer risk when considering whether or how much to drink—and for public health professionals and community groups to highlight this risk through expanded education efforts, including for health care providers, who should discuss the risk in clinical settings.

This was the eighth advisory issued by Murthy who, as the 21st U.S. Surgeon General, is the “nation’s doctor.” Other advisories have concerned loneliness and isolation, social media use and youth mental health, and mental health and wellbeing of parents.

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