23,126 US cancer deaths a year were tied to alcohol in 2023, up from 11,361 in 1990, with the share of cancer mortality attributable to alcohol doubling among adults 20 and older.
One standard drink a day can raise risk, the study said, linking alcohol to breast, liver, colorectal, head and neck, esophageal, pancreatic, stomach and other cancers through DNA damage, hormone changes and inflammation.
Men and adults 55 and older saw the greatest impact, but colorectal cancer led alcohol-attributable cancer deaths in men aged 20 to 54 and ranked second in women that age group, behind breast cancer.
The findings add to pressure on US drinking guidance after the Trump administration in January dropped sex-specific daily limits and instead advised Americans to drink less for better overall health.