Former U.S. Surgeon General Vivek Murthy released a January advisory to the public about the direct link between alcohol consumption and increased cancer risk. Now, work at the University of Minnesota’s Masonic Cancer Center may give a better view into that link.

University of Minnesota Public Health professor Silvia Balbo’s research is cited in the advisory. Balbo, a co-leader of the Masonic Cancer Center’s Carcinogenesis and Chemoprevention Program at the University, studies the interaction of DNA and chemicals.

She continues to investigate how acetaldehyde, a chemical compound produced by the body during the metabolism of alcohol, damages DNA. 

Even with the center’s continued study, Balbo said we still have much to learn about how the body’s interaction with alcohol can lead to certain cancers.

The advisory, which outlined alcohol consumption as a leading preventable cause of seven different types of cancer, called for greater public awareness regarding the risk of even moderate alcohol consumption. Despite this link between alcohol consumption and cancer being established nearly four decades ago, less than half of U.S. adults are aware of the risk, according to the report.  

Murthy detailed in the advisory that alcohol use contributes to nearly 100,000 cancer cases and 20,000 related deaths each year. 

Balbo said her research aims to support the information, guidelines and scientific evidence that allow the public to make more informed decisions about alcohol consumption. 

“In my lab, we are trying to understand the hypothesis that acetaldehyde ultimately is damaging DNA and leading to the carcinogenic process starting,” Balbo said. “The other big question is, ‘Okay, if that’s true, then how much alcohol do I need to drink,’ or is there a safe level?”

The study cited in the advisory found that controlled alcohol doses increased DNA damage. The study also aimed to identify markers for those at higher risk of developing certain cancers. 

Balbo said around 30% of people from countries in Eastern Asia — such as China, Japan, Taiwan and Korea — can not properly break down acetaldehyde as a result of their genetics. When drinking alcohol, these individuals experience flushing, when the face becomes red and hot, along with other symptoms. 

“People from these particular areas that have this genetic background and still drink are at much higher risk for the head and neck cancers if they keep on drinking alcohol,” Balbo said. 

Balbo said adding warning labels to alcoholic beverages, outlined in the advisory as a necessary next step for alcohol-related cancer prevention, would be important for consumers. 

Balbo added that the addition of labels on alcoholic products should be a means of informing the public, not stigmatizing consumption as a whole.

“It’s about knowing that this is posing a risk, and then you decide what you want to do,” Balbo said. “The other piece is that none of these risks are in a vacuum, each of us has our own risks.”

Current research does not support the idea that there are benefits to light or moderate consumption, something previously believed to be true, according to an article by The New York Times. 

As a whole, American views on drinking have seemed to change over the years as well. 

In recent polling by Gallup, 45% of Americans say drinking one or two alcoholic drinks per day is unhealthy. Younger adults, ages 18 to 34, view alcohol consumption negatively at higher rates. 

Self-reported alcohol consumption among young adults has trended downwards since its peak in the early 2000s, according to Gallup.

At the University, high-risk drinking among students has declined by 10% since 2015, according to Boynton Health’s 2024 College Student Health Survey Report. 

Boynton public health director Michelle Trumpy said the Twin Cities campus survey found that high-risk drinking is steadily decreasing, with more students abstaining from alcohol and changing drinking behaviors on campus. 

The survey, conducted every two to three years, revealed high-risk drinking declined by 16 percentage points from 2007 to 2024, according to Trumpy. She said abstinence from drinking increased six percentage points, and the average number of drinks consumed per week dropped from 4.2 to 2.9 over the same period. 

Trumpy said there are many campus policies and programs available to students supporting reduction in high-risk drinking, a focus that aligns with the surgeon general’s advisory in promoting healthier behaviors around alcohol consumption. 

“We know that the alcohol programming, getting the data on alcohol use, acting on that data, bringing campus partners together to talk about those healthy environments, that is all part of our strategy to address alcohol use on campus,” Trumpy said. 

While studies have found drinking-related habits to be on the decline at the University, some students believe these habits still stand as a major factor in campus life.

Second-year veterinary student Sunil Kancherla said he feels drinking is more normalized at the University compared to his undergraduate experience at Ohio State University. 

Kancherla said warning labels on alcoholic beverages might not significantly alter his drinking behavior as someone who occasionally drinks, but could help raise awareness of the risks.

“I would assume that, more or less, everyone does know that alcohol in excess is bad,” Kancherla said. “I just don’t know to what degree people understand that any alcohol is bad, the same way that people understand that any cigarettes are bad.” 

Fourth-year student Adele Vincent said they have encountered mixed attitudes towards drinking among students, ranging from those who avoid it entirely to those who drink heavily. With how heavy drinking is normalized at larger universities, Vincent said the addition of warning labels that disclose the risk would be important regardless of how students respond.

“Sometimes I do see warning labels on things, and I kind of have that naive 21-year-old thought, that’s not going to happen to me,” Vincent said. “I would like to think that some people would take it seriously.”

According to a 2023 NIH survey, full-time college students are more likely to participate in high-risk drinking or binge drinking, consuming five or more drinks in one sitting. Binge drinking, defined as a pattern of drinking that brings a person’s BAC to 0.08%, exposes a person’s body to a high amount of alcohol in a short period and has the potential to elevate these cancer risks.

Balbo said there is not enough scientific evidence currently to connect the impact of age and early drinking with cancer risk, but it is one of the questions research is trying to better understand. Balbo added that the suggested warning labels outlined in the advisory could have a positive impact on young people who drink or participate in high-risk drinking. 

“The general idea is that you can experience drinking alcohol, but it’s just a matter of doing it in moderation and knowing about some of the risks that are associated,” Balbo said. 

The U.S. Dietary Guidelines is expected to eliminate its long-standing recommendation advising adults to limit alcohol consumption to one or two drinks per day in the coming month, according to a report by Reuters. 

Balbo said this is a missed opportunity for clearer guidance amidst the growing evidence of the risks associated with alcohol consumption, detailed in the advisory and her research. 

“It’s true that it’s hard to be precise and determine exact amounts, but I think that giving some guidelines on what drinking in moderation means would have been more useful,” Balbo said. “I think that people will probably no longer use the U.S. guidelines to understand what that is, and will have to refer to something else.”