A national survey of 6,793 US adults found that just 37.1% of respondents believed drinking alcohol increases the risk of developing cancer, while more than half said they did not know whether there is a connection.
Among the respondents, 9.1% said alcohol does not affect cancer risk, 1% said it decreases cancer risk, and 52.9% answered that they didn't know whether alcohol affected cancer risk. Adults who had consumed alcohol in the past month were more likely to believe that it does not affect cancer risk. The respondents who believed cancer is nonfatal or not preventable were also more likely to say that alcohol does not affect cancer risk. Current smokers were more likely compared with nonsmokers to be unaware of the cancer risk associated with alcohol consumption.
Lower education levels were associated with greater uncertainty. Those without post-college education were more likely to say they didn't know compared with those who had advanced degrees. Non-Hispanic Black respondents were more likely compared with non-Hispanic White respondents to answer that they didn't know the risk of cancer associated with alcohol consumption.
“Individuals who drink alcohol were more likely to believe that alcohol consumption has no effect on cancer risk, which is alarming, given the growing burden of alcohol-related cancers in the United States,” said lead study author Joël Fokom Domgue, MD, of The University of Texas MD Anderson Cancer Center, and colleagues.
The mean participant age was 48.9 years; 51.6% were male and 48.4% female. More than half (51.9%) reported alcohol use in the past month, and about 9.8% reported a personal history of cancer. Participants were asked, “In your opinion, how does drinking alcohol affect the risk of getting cancer?” and could respond “decreases,” “no effect,” “increases,” or “don’t know.”
The researchers used data from the 2024 Health Information National Trends Survey, a nationally representative mail survey of US adults. Weighted multinomial logistic regression models were used to estimate associations between demographic, behavioral, and belief factors and alcohol–cancer risk perceptions. Variables included age, sex, race and ethnicity, education, income, smoking status, alcohol use, and beliefs about cancer preventability and fatality.
Additional model covariates—such as urban or rural residence, income, visit frequency, the belief that “everything causes cancer,” and family cancer history—were also included but weren't statistically significant.
The study quantified associations using adjusted odds ratios, reported in the study’s data table, which showed that past-month drinking, lower education, and beliefs minimizing cancer severity were independently associated with uncertainty or disbelief about alcohol’s cancer risk.
Alcohol-related cancer sites were defined as cancers of the oral cavity, throat, larynx, esophagus, liver, breast, colon, and rectum. The analyses incorporated survey weighting and design to ensure national representation. The data set was publicly available and used de-identified data, and the study was exempt from institutional review board review.
The researchers reported several limitations, including the cross-sectional design, which didn't allow causal interpretation, self-reported measures that may have been affected by recall or social desirability bias, and small subgroup sizes that may have limited precision.
The researchers stated that the persistence of uncertainty and misconceptions about alcohol’s role in cancer development may influence ongoing drinking behaviors in the US. They noted that addressing these misbeliefs could support adherence to national alcohol consumption guidelines recently endorsed by the US Surgeon General.
Full disclosures can be found in the published study.
Source: JAMA Oncology