1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Alcohol Use and Cancer
Presented at Cancer Support Now’s Conference 2023
Garry Kelley
Excessive Alcohol Use Prevention
Epidemiologist
New Mexico Department of Health
Epidemiology and Response Division
Substance Use Epidemiology Section

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Presenter Disclaimer
This presentation is partially supported by the
Centers for Disease Control and Prevention of the
U.S. Department of Health and Human Services
(HHS) as part of a financial assistance award
totaling $166,667. The contents are those of the
author(s) and do not necessarily represent the official
views of, nor an endorsement, by CDC/HHS, or the
U.S. Government.

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
2020-2025 Dietary Guidelines on Alcohol
• The 2020-2025 Dietary Guidelines
for Americans recommendations
• Do NOT recommend that individuals
who do not drink alcohol start drinking
• Drinking less alcohol is better
• Adults of legal drinking age can choose
• NOT to drink, OR
• Drink in moderation by limiting intake
to 2 drinks or less in a day for men or 1
drink or less in a day for women
• There are some people who should not
drink any alcohol, including those who
are suffering from certain medical
conditions or taking certain prescription
or over-the-counter medications that can
interact with alcohol
Data source: Centers for Disease Control and Prevention (CDC). Alcohol Use and Your Health.
https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
What is a Standard Drink in the US?
• Contains 0.6 ounces (14.0 grams or 1.2 tablespoons) of pure alcohol
• Generally, takes the liver about 1 hour to process 1 standard drink
• 1 standard drink will on average, produce a blood alcohol
concentration (BAC) of between 0.02% and 0.04%
Data sources: Centers for Disease Control and Prevention (CDC). Alcohol Use and Your Health AND
National Institute on Alcohol Abuse and Alcoholism. https://www.niaaa.nih.gov/alcohols-effects-
health/overview-alcohol-consumption/what-standard-drink

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Excessive Alcohol Use Definitions
• Most people who drink excessively are not alcoholics or
alcohol dependent
Data source: Centers for Disease Control and Prevention (CDC). Alcohol Use and Your Health.
https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Alcohol Use Among Adults in United
States and New Mexico, BRFSS, 2021
• Data from the Behavioral Risk
Factor Surveillance Survey
(BRFSS) in 2021 found
Nationally that:
• 53% of adults reported using
alcohol within the past month
• 15% of adults binge drank within
the past month
• While in New Mexico for 2021,
• 46% of adults reported using
alcohol within the past month
• 15% of adults binge drank within
the past month
Data source: Centers for Disease Control and Prevention (CDC). BRFSS Prevalence & Trends Data.
https://www.cdc.gov/brfss/brfssprevalence/

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Increased Risks from Binge Drinking
Alcohol
Data source: CDC, MMWR, Screening for Alcohol Use and Brief Counseling of Adults — 13 States and the
District of Columbia, 2017 https://www.cdc.gov/mmwr/volumes/69/wr/mm6910a3.htm?s_cid=mm6910a3_w
CDC, https://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm
• Potential Effects
• Alcohol poisoning
• Dangers to the fetus in pregnant
women including miscarriage, stillbirth
or fetal alcohol spectrum disorders
• Injuries including vehicle crashes,
falls, drownings or burns
• Sexual risk behaviors like unprotected
sex that could lead to sexually
transmitted infections, HIV or
unintended pregnancy
• Violent or suicidal behaviors
• Memory and learning problems

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Alcohol Use Among Individuals
Diagnosed with Cancer (Nationally)
• Data from the 2000-2017 National Health Interview
Survey of 34,080 adults diagnosed with cancer
found:
• 56.5% reported using alcohol
• 34.9% said that their alcohol consumption exceeded
moderate drinking guidelines
• 21.0% admitted to binge drinking
• The risk for drinking alcohol at all levels increased
with
• younger age
• current or former smoking history
• participation in the more recent survey period
• The same associations were observed in patients
who reported a cancer diagnosis of 5 or more
years before the survey was administered.
Sanford NN, et al. Alcohol Use Among Patients With Cancer and Survivors in the United States,
2000-2017. J Natl Compr Canc Netw. 2020 Jan;18(1):69-79. doi: 10.6004/jnccn.2019.7341. PMID:
31910381.

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Other Short-Term Effects of Excessive
Alcohol Use
• Injuries (i.e. motor vehicle crashes, falls, drownings, and
burns).
• Violence, including homicide, suicide, sexual assault, and
intimate partner violence.
• Alcohol poisoning, a medical emergency that results from
high blood alcohol levels.
• Sexual risk behaviors, including unprotected sex or sex
with multiple partners.
• Miscarriage, stillbirth, and fetal alcohol spectrum disorders
(FASDs) among pregnant women.
Data source: Centers for Disease Control and Prevention (CDC). Alcohol Use and Your Health.
https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Other Long-Term Effects of Excessive
Alcohol Use
• High blood pressure, heart disease, stroke, liver disease,
and digestive problems
• Weakening of the immune system, increasing the
chances of getting sick.
• Learning and memory problems
• Mental health concerns, including depression and anxiety
• Social problems, including family problems, job-related
problems, and unemployment
• Alcohol use disorders, or alcohol dependence.
Data source: Centers for Disease Control and Prevention (CDC). Alcohol Use and Your Health.
https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Background of Alcohol and Cancer Risk
• Alcohol is recognized as a known carcinogen (a
chemical that causes cancer) by several official
organizations including the US National Toxicology
Program, and the International Agency for Research on
Cancer (IARC)
• Greater amounts of alcohol consumed over time
increases risk for cancer rather than the type of
alcoholic beverage consumed.
• All alcoholic drinks (including red and white wine, beer,
and liquor) can increase the risk for cancer
• Most scientific evidence suggests that it is the ethanol in
alcoholic drinks that increases the risk for cancer
• 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of
80-proof liquor — contains about ½ ounce of ethanol
Data source: National Cancer Institute. Alcohol and Cancer Risk.
https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
How Alcohol Causes Cancer
• Alcohol can damage a cell so that it can begin
growing out of control and creates a cancer tumor*
• The human body breaks alcohol down into a chemical
called acetaldehyde
• Acetaldehyde damages deoxyribonucleic acid (DNA), which is
the cell’s “instruction manual” that controls a cell’s normal
growth and functions.
• Acetaldehyde prevents your body from repairing damage
• Alcohol estimated to be the 2nd leading risk factor
for cancer after smoking^
Data source: *) Centers for Disease Control and Prevention (CDC). Alcohol and Cancer
https://www.cdc.gov/cancer/alcohol/index.htm
^) GBD 2019 Cancer Risk Factors Collaborators. The global burden of cancer attributable to risk
factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019. Lancet
https://pubmed.ncbi.nlm.nih.gov/35988567/

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Cancers Directly Related to Alcohol
Drinking alcohol raises your
risk of getting six kinds of
cancer—
• Mouth and throat
• Voice box (larynx)
• Esophagus
• Colon and rectum
• Liver
• Breast (in women)
Data source: NIH, National Cancer Institute, Alcohol and Cancer Risk
https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Risk Factors that Modify Alcohol’s
Effects on Cancer
• People who use BOTH alcohol and tobacco have
much greater risks of developing the following
cancers than people who use either alcohol OR
tobacco alone
• oral cavity
• pharynx (throat)
• larynx
• esophagus
• A person’s risk of alcohol-related cancers is
influenced by genes that encode enzymes involved in
metabolizing (breaking down) of alcohol
• alcohol dehydrogenase (ADH)
• aldehyde dehydrogenase 2 (ALDH2)
Data source: National Cancer Institute. Alcohol and Cancer Risk.
https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Yearly Estimates of Alcohol-Attributable
Cancer Deaths, 2015-2019
• Nationally, alcohol directly
caused or contributed to
over 18,900 cancer deaths
per year
• In New Mexico, alcohol
caused or contributed to over
120 cancer deaths per year
• 78% occurred in males
• 64% occurred in individuals
aged 65 years or older
• 29% were liver cancers
Data source: Centers for Disease Control and Prevention (CDC). Alcohol and Public Health:
Alcohol-Related Disease Impact (ARDI)
https://nccd.cdc.gov/DPH_ARDI/Default/Default.aspx

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Facts About Alcohol and Risk for
Cancer
• All alcoholic drinks (including
red and white wine, beer, and
liquor) can increase the risk for
cancer
• Research has shown that when
you stop drinking, the risk for
alcohol-related cancers declines
over time (years)
• It may take years for the risks of
cancer to return to those of
individuals who never drank
alcohol
Data source: National Cancer Institute. Alcohol and Cancer Risk.
https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Alcohol Use During Or After Cancer
Treatment
• Since alcohol can increase cancer risk, people may want
to consider avoiding drinking after cancer diagnosis.
• Patients may want to check with their health care team
about whether it is safe to drink alcohol during or
immediately following chemotherapy treatment
• Alcohol can worsen the side effects of chemotherapy and
drugs used during cancer treatment. These side effects include
nausea, dehydration and mouth sores.
• The link between alcohol and cancer recurrence (i.e.
coming back) is NOT known, especially for those who
have completed cancer treatment.
Data source: American Cancer Society. Alcohol use and cancer
https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Community Preventive Services Task Force (CPSTF)
recommendations of what works in Preventing
Excessive Alcohol Consumption
Data source: Centers for Disease Control and Prevention (CDC). The Community Guide
https://www.thecommunityguide.org/resources/what-works-preventing-excessive-alcohol-
consumption.html

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Check Your Drinking With An Online Tool.
Make a Plan to Drink Less.
Check your drinking, get personalized feedback, and create a
personalized plan for drinking less:
https://www.cdc.gov/alcohol/checkyourdrinking/index.html

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Conclusions
• Alcohol is known to cause several types of cancer
• Effects increase with concurrent tobacco use
• About half the general population and cancer
patients/survivors use alcohol
• 1 in 5 cancer patients/survivors binge drink
• Alcohol can make side effects of cancer treatment
worse
• Link between alcohol and risk of
getting cancer again is NOT known
• Patients/Survivors may want to
consider discussing their alcohol and
tobacco use with their doctor

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Excessive Alcohol Use Prevention Resources
• SAMHSA’s Implementing
Community-Level Policies to
Prevent Alcohol Misuse
https://www.samhsa.gov/resource/ebp/impl
ementing-community-level-policies-
prevent-alcohol-misuse
• CDC’s Community Guide on
Excessive Alcohol Consumption
https://www.thecommunityguide.org/topic
s/excessive-alcohol-consumption.html

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Other Addiction Related Resources
• NIH’s National Institute on Alcohol
Abuse and Alcoholism
contains education materials, professional
resources, and has Alcohol Treatment
Navigator https://www.niaaa.nih.gov/
Alcohol Navigator:
https://alcoholtreatment.niaaa.nih.gov/how-to-
find-alcohol-treatments
• SAMHSA’s Alcohol, Tobacco, and
Other Drugs
contains education materials, professional
resources, public campaign material, drug use
surveys, and Behavioral Health Treatment
Services Locator
https://findtreatment.samhsa.gov/

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
Other Addiction Related Resources (II)
• Recovery.org (Formerly NCADD):
education resources and find nearby support groups
https://recovered.org/
• Alcohol Awareness:
addiction helpline (885-955-0771) and resources
https://alcoholawareness.org/
• Alcoholics Anonymous:
resources and meetings
https://www.aa.org/

1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org
• SAMHSA’s National Helpline
• 1-800-662-HELP (4357)
https://www.samhsa.gov/find-help/national-helpline
• New Mexico Crisis and Access Line
• 1-855-NMCRISIS (662-7474) https://nmcrisisline.com/
• New Mexico Peer to Peer Warmline
• 1-855-466-7100 https://nmcrisisline.com/
• NM DPS’s Drunk Busters Hotline (End DWI)
• 877-394-4258 (#DWI or #394 for cellphones)
https://www.endwi.com/drunk-busters
• National Suicide Prevention Lifeline
• 988 https://988lifeline.org/
• National Domestic Violence Hotline
• 1-800-799-7233 https://www.thehotline.org/
Hotline Resources
Data source: New Mexico Department of Health. Crisis Lines
https://www.nmhealth.org/contact/crisis/