The U.S. Surgeon General Dr. Vivek Murthy has issued a health advisory for the link between alcohol and the risk of cancer. Published on Jan. 3, it notes that alcohol consumption is “the third leading preventable cause of cancer in the country, after tobacco and obesity.” He is calling for an update of the existing health warning label found on alcoholic drinks to now include a risk of cancer.

“Alcohol is a well-established, preventable cause of cancer responsible for about 100,000 cases of cancer and 20,000 cancer deaths annually in the United States — greater than the 13,500 alcohol-associated traffic crash fatalities per year in the U.S. — yet the majority of Americans are unaware of this risk,” Dr. Murthy said in a press release. “This Advisory lays out steps we can all take to increase awareness of alcohol’s cancer risk and minimize harm.”

Americans’ Alcohol Habits and Awareness of Cancer Risks

In America, 72% of adults said they consumed one or more drinks on a weekly basis between 2019 and 2020, but less than half are aware that alcohol is a carcinogen, per the advisory. In 2020, 741,300 cases of cancer were attributed to alcohol consumption globally.

According to a report by the National Toxicology Program of the U.S. Department of Health and Human Services, alcoholic beverages are a known human carcinogen — is linked to at least seven types of cancer, including breast cancer and esophageal cancer. Regardless of the type of alcohol, cancer risks  may start to increase around one or fewer drinks per day, according to the advisory.

How Alcohol Impacts Cancer Risk: Inflammation and Gut Microbiome Changes

“Some of this is happening through chronic inflammation. We also know that alcohol changes the microbiome, so those are the bacteria that live in your gut, and that can also increase the risk,” CBS News medical contributor Dr. Céline Gounder, who’s also the editor-at-large for public health at KFF Health News, said on CBS Mornings in September.

Alcohol and Cancer: What the Science Reveals

She added that studies have shown that there’s no such thing as a “safe amount” of alcohol, especially for those who have underlying medical conditions.

Changing Alcohol Consumption Trends Among Younger Americans

The advisory comes as younger Americans are consuming less alcohol. Two thirds of adults aged between 18 and 34 say alcohol consumption negatively affects health, as opposed to under 40% of people aged between 35 and 54, as well as 55 and over, according to a survey published by Gallup in August.