Despite decades of evidence showing alcohol as a known carcinogen, the majority of U.S. adults remain unaware that drinking increases cancer risk, according to a new study published in JAMA Oncology on 30 October 2025.
The research, led by Dr Ernest Fokom Domgue and colleagues at the University of Texas MD Anderson Cancer Center, USA, highlights persistent gaps in public understanding that may hamper effective cancer prevention messaging.
The analysis drew on data from the 2024 Health Information National Trends Survey, a nationally representative sample of 6,793 U.S. adults (mean age 48.9 years). Participants were asked how they believed alcohol affects the risk of developing cancer.
Key findings:
- Only 37.1% of respondents correctly identified alcohol as increasing cancer risk.
- 52.9% said they did not know how alcohol affects cancer risk.
- 9.1% believed alcohol has no effect, while around 1% thought it reduces risk.
- Current drinkers were significantly more likely to believe alcohol has no effect on cancer risk (adjusted OR 1.76, 95% CI 1.18–2.64).
- Uncertainty and misbeliefs were more common among current smokers, non-Hispanic Black respondents, individuals with lower educational attainment, and those who believed cancer is not preventable.
The findings reveal a striking paradox: those most likely to drink alcohol are also the least likely to believe it poses a cancer risk. As the authors note, “Despite the recognized contribution of alcohol to cancer incidence and mortality, recent evidence suggests that awareness of the link between alcohol and cancer remains low in the US.”
Alcohol is classified by the World Health Organization’s International Agency for Research on Cancer as a Group 1 carcinogen, causally linked to multiple malignancies, including breast, colorectal, oesophageal, head and neck, and liver cancers. Yet, as the study shows, public awareness of this fact remains poor — a disconnect that has major implications for clinical practice.
For oncologists, haematologists, and primary care physicians, these findings underscore the importance of clear, evidence-based communication with patients. The authors emphasise that “individuals’ beliefs play a key role in the adoption of healthy behavioural changes,” suggesting that addressing misconceptions about alcohol and cancer risk could be a powerful step toward prevention.
The study’s cross-sectional design means causality cannot be inferred, and beliefs may not always translate to behaviour change. However, the results offer a valuable snapshot of the public’s understanding of alcohol-related cancer risk and highlight the need for more effective public health messaging.
From a health-system perspective, integrating consistent alcohol-risk communication into cancer prevention guidelines and clinical conversations could help close this gap. Targeted interventions may be particularly necessary for populations with lower educational attainment or higher consumption rates.
In conclusion, the authors call for renewed attention to alcohol as a modifiable risk factor — and for clinicians to lead by example in communicating that message. Changing public beliefs, they argue, remains an essential step toward reducing the burden of alcohol-related cancers.
Paper: Fokom Domgue J, et al. Beliefs About the Effect of Alcohol Use on Cancer Risk in the US Adult Population. JAMA Oncol. Published online October 30, 2025. Access online here.
