Science
Why the U.S. surgeon general wants cancer warning labels on alcoholic drinks
Alcoholic drinks are a leading cause of cancer and should carry a warning about that risk on their labels, the U.S. surgeon general said Friday.
Alcohol is a factor in nearly 100,000 newly diagnosed cancers each year and roughly 20,000 deaths from the disease, U.S. Surgeon General Vivek Murthy said in an advisory intended to focus the public’s attention on the health risk. By comparison, traffic accidents tied to drinking kill about 13,500 Americans each year.
“Alcohol consumption is the third leading preventable cause of cancer in the United States, after tobacco and obesity,” the 22-page advisory said. “While scientific evidence for this connection has been growing over the past four decades, less than half of Americans recognize it as a risk factor for cancer.”
Labels on bottles and cans of alcoholic beverages already warn about drinking while pregnant. They also warn about drinking before driving or operating other machinery. In California, the voter-approved Proposition 65 also requires businesses that serve or sell alcoholic beverages to provide a warning about health risks, including cancer.
Any decision to update or expand the label would require congressional approval, an uncertain prospect. Murthy was appointed by President Biden, who has a little more than two weeks left in office. President-elect Donald Trump has picked Janette Nesheiwat, an executive at a New York-based chain of urgent care clinics, as his nominee for surgeon general.
Executives in the beer, wine and spirits industry said Friday that the scientific data linking alcohol to cancer are mixed.
Amanda Berger, senior vice president at the Distilled Spirits Council, noted that a recent report by the National Academies of Sciences, Engineering, and Medicine found that alcohol was associated with a higher risk of breast cancer but did not find such associations with other types of cancer.
That report also concluded that moderate alcohol consumption is associated with lower risks of all-cause mortality and cardiovascular disease, compared with never consuming alcohol.
“The current health warning on alcohol products has long informed consumers about the potential risks of the consumption of alcohol,” Berger said. “Many lifestyle choices carry potential risks, and it is the federal government’s role to determine any proposed changes to the warning statements based on the entire body of scientific research.”
The surgeon general’s advisory said that cancers of the colorectum, esophagus, liver, mouth, throat and larynx are all tied to drinking, as is breast cancer in women. The risk of developing breast, mouth or throat cancers may increase with less than one drink per day, it said.
(Office of the U.S. Surgeon General)
Yet more than half of Americans are unaware that their drinking behavior affects their cancer risk. A survey by the American Institute for Cancer Research found that 89% of Americans recognized that smoking causes cancer and 53% knew that obesity was a risk factor, but only 45% realized that alcohol could cause cancer as well.
Nearly half of alcohol-related cancers in the U.S. are breast cancers in women, according to a study published by the American Cancer Society. About 1 in every 6 female breast cancers is due to alcohol, and the disease accounts for about 60% of all alcohol-related cancer deaths in women.
As a result, drinking is a bigger cancer risk for women than men. In 2019, about 54,330 women were diagnosed with a cancer that resulted from drinking, as were roughly 42,400 men. About 60% of alcohol-related cancer deaths in women are due to breast cancer, while liver cancer and colorectal cancer are responsible for about 54% of alcohol-related cancer deaths in men.
For women who consume less than one drink a week, the absolute risk of developing an alcohol-related cancer is 16.5%. Having one drink per day increases that risk to 19%, and having two drinks each day raises it to 21.8%, according to the advisory.
For men, drinking once a week is tied to a 10% absolute risk of an alcohol-related cancer. That risk rises to 11.4% by having one drink per day, and to 13.1% by having two drinks per day, the advisory says.
The World Health Organization’s International Agency for Research on Cancer says alcohol is a Group 1 carcinogen, putting it in the company of tobacco, asbestos and ultraviolet radiation. The U.S. National Toxicology Program declared in 2000 that alcohol causes cancer in humans, and organizations including the Centers for Disease Control and Prevention, the National Cancer Institute, the American Cancer Society and the American Assn. for Cancer Research agree that at least seven kinds of cancer are related to drinking.
There is also evidence to suggest that drinking contributes to skin, prostate, pancreatic and stomach cancers, though more research is needed, the surgeon general’s advisory says.
Scientists first linked alcohol consumption to certain cancers nearly 50 years ago, and the evidence showing that drinking is a risk factor for at least seven types of cancer has grown since then, the advisory says.
For instance, an observational study of 28 million people in 195 countries and territories found that the more alcohol a person consumed, the higher their risk of cancer. A study involving more than 1 million women found that those who had up to 1 drink per day were 10% more likely to get breast cancer compared with those who abstained. Likewise, a study with 36,000 people found that those who consumed about a drink per day were 40% more likely to develop mouth cancer than people who didn’t drink.
Laboratory experiments have shown how alcohol leads to cancer.
When alcohol is metabolized in the body, it breaks down into a chemical called acetaldehyde that can attach itself to DNA. The resulting damage can trigger the uncontrolled cell growth that leads to cancer.
Drinking also creates unstable molecules called reactive oxygen species that can interfere with DNA, proteins and essential fats. They also increase inflammation, which makes the body more hospitable to cancer.
There is also evidence that alcohol fuels breast cancers by affecting levels of estrogen and other hormones, and that other kinds of carcinogens — such as those found in tobacco smoke — are more easily absorbed in the body when they are dissolved in alcohol.
The companies selling alcoholic beverages say they have long urged consumers to drink the beverages safely.
“The U.S. beer industry has been a champion of responsible consumption for decades,” a spokesperson for the Beer Institute said Friday. “We encourage adults of legal drinking age to make choices that best fit their personal circumstances, and if they choose to drink, to consume alcohol beverages in moderation.”
Dr. Laura Catena, a winemaker and physician, said that she would “welcome any kind of alert or communication from the surgeon general about the cancer risks of heavy alcohol drinking,” but that it shouldn’t go beyond the established science.
The American Assn. for Cancer Research says alcohol use is responsible for 5.4% of all cancer cases in the U.S. That makes it a bigger risk factor than exposure to UV radiation, poor diet, and infections from pathogens like hepatitis and the human papillomavirus. (For comparison, 19.3% of U.S. cancers are attributable to smoking, according to the association.)
Studies suggest that people who cut back on alcohol or eliminate it can reduce their risk of these cancers by 8%, and reduce their overall cancer risk by 4%.
The Dietary Guidelines for Americans from the U.S. Departments of Agriculture and Health and Human Services say there is no health reason for nondrinkers to start consuming alcohol. Those who do drink can minimize their risk by limiting their intake to no more than one drink per day for women and no more than two drinks per day for men.
A 5-ounce glass of wine, 12-ounce bottle of beer or 1.5-ounce tumbler of distilled spirits count as a single drink.
The surgeon general’s advisory says about 83% of alcohol-related cancer deaths occur in people who exceed those limits. But that means 17% of deaths were in people who engaged in moderate drinking.
Science
AI windfall helps California narrow projected $3-billion budget deficit
SACRAMENTO — California and its state-funded programs are heading into a period of volatile fiscal uncertainty, driven largely by events in Washington and on Wall Street.
Gov. Gavin Newsom’s budget chief warned Friday that surging revenues tied to the artificial intelligence boom are being offset by rising costs and federal funding cuts. The result: a projected $3-billion state deficit for the next fiscal year despite no major new spending initiatives.
The Newsom administration on Friday released its proposed $348.9-billion budget for the fiscal year that begins July 1, formally launching negotiations with the Legislature over spending priorities and policy goals.
“This budget reflects both confidence and caution,” Newsom said in a statement. “California’s economy is strong, revenues are outperforming expectations, and our fiscal position is stable because of years of prudent fiscal management — but we remain disciplined and focused on sustaining progress, not overextending it.”
Newsom’s proposed budget did not include funding to backfill the massive cuts to Medicaid and other public assistance programs by President Trump and the Republican-led Congress, changes expected to lead to millions of low-income Californians losing healthcare coverage and other benefits.
“If the state doesn’t step up, communities across California will crumble,” California State Assn. of Counties Chief Executive Graham Knaus said in a statement.
The governor is expected to revise the plan in May using updated revenue projections after the income tax filing deadline, with lawmakers required to approve a final budget by June 15.
Newsom did not attend the budget presentation Friday, which was out of the ordinary, instead opting to have California Director of Finance Joe Stephenshaw field questions about the governor’s spending plan.
“Without having significant increases of spending, there also are no significant reductions or cuts to programs in the budget,” Stephenshaw said, noting that the proposal is a work in progress.
California has an unusually volatile revenue system — one that relies heavily on personal income taxes from high-earning residents whose capital gains rise and fall sharply with the stock market.
Entering state budget negotiations, many expected to see significant belt tightening after the nonpartisan Legislative Analyst’s Office warned in November that California faces a nearly $18-billion budget shortfall. The governor’s office and Department of Finance do not always agree, or use the LAO’s estimates.
On Friday, the Newsom administration said it is projecting a much smaller deficit — about $3 billion — after assuming higher revenues over the next three fiscal years than were forecast last year. The gap between the governor’s estimate and the LAO’s projection largely reflects differing assumptions about risk: The LAO factored in the possibility of a major stock market downturn.
“We do not do that,” Stephenshaw said.
Among the key areas in the budget:
Science
California confirms first measles case for 2026 in San Mateo County as vaccination debates continue
Barely more than a week into the new year, the California Department of Public Health confirmed its first measles case of 2026.
The diagnosis came from San Mateo County, where an unvaccinated adult likely contracted the virus from recent international travel, according to Preston Merchant, a San Mateo County Health spokesperson.
Measles is one of the most infectious viruses in the world, and can remain in the air for two hours after an infected person leaves, according to the CDPH. Although the U.S. announced it had eliminated measles in 2000, meaning there had been no reported infections of the disease in 12 months, measles have since returned.
Last year, the U.S. reported about 2,000 cases, the highest reported count since 1992, according to CDC data.
“Right now, our best strategy to avoid spread is contact tracing, so reaching out to everybody that came in contact with this person,” Merchant said. “So far, they have no reported symptoms. We’re assuming that this is the first [California] measles case of the year.”
San Mateo County also reported an unvaccinated child’s death from influenza this week.
Across the country, measles outbreaks are spreading. Today, the South Carolina State Department of Public Health confirmed the state’s outbreak had reached 310 cases. The number has been steadily rising since an initial infection in July spread across the state and is now reported to be connected with infections in North Carolina and Washington.
Similarly to San Mateo’s case, the first reported infection in South Carolina came from an unvaccinated person who was exposed to measles while traveling internationally.
At the border of Utah and Arizona, a separate measles outbreak has reached 390 cases, stemming from schools and pediatric centers, according to the Utah Department of Health and Human Services.
Canada, another long-standing “measles-free” nation, lost ground in its battle with measles in November. The Public Health Agency of Canada announced that the nation is battling a “large, multi-jurisdictional” measles outbreak that began in October 2024.
If American measles cases follow last year’s pattern, the United States is facing losing its measles elimination status next.
For a country to lose measles-free status, reported outbreaks must be of the same locally spread strain, as was the case in Canada. As many cases in the United States were initially connected to international travel, the U.S. has been able to hold on to the status. However, as outbreaks with American-origin cases continue, this pattern could lead the Pan American Health Organization to change the country’s status.
In the first year of the Trump administration, officials led by Health Secretary Robert F. Kennedy Jr. have promoted lowering vaccine mandates and reducing funding for health research.
In December, Trump’s presidential memorandum led to this week’s reduced recommended childhood vaccines; in June, Kennedy fired an entire CDC vaccine advisory committee, replacing members with multiple vaccine skeptics.
Experts are concerned that recent debates over vaccine mandates in the White House will shake the public’s confidence in the effectiveness of vaccines.
“Viruses and bacteria that were under control are being set free on our most vulnerable,” Dr. James Alwine, a virologist and member of the nonprofit advocacy group Defend Public Health, said to The Times.
According to the CDPH, the measles vaccine provides 97% protection against measles in two doses.
Common symptoms of measles include cough, runny nose, pink eye and rash. The virus is spread through breathing, coughing or talking, according to the CDPH.
Measles often leads to hospitalization and, for some, can be fatal.
Science
Trump administration declares ‘war on sugar’ in overhaul of food guidelines
The Trump administration announced a major overhaul of American nutrition guidelines Wednesday, replacing the old, carbohydrate-heavy food pyramid with one that prioritizes protein, healthy fats and whole grains.
“Our government declares war on added sugar,” Health and Human Services Secretary Robert F. Kennedy Jr. said in a White House press conference announcing the changes. “We are ending the war on saturated fats.”
“If a foreign adversary sought to destroy the health of our children, to cripple our economy, to weaken our national security, there would be no better strategy than to addict us to ultra-processed foods,” Kennedy said.
Improving U.S. eating habits and the availability of nutritious foods is an issue with broad bipartisan support, and has been a long-standing goal of Kennedy’s Make America Healthy Again movement.
During the press conference, he acknowledged both the American Medical Association and the American Assn. of Pediatrics for partnering on the new guidelines — two organizations that earlier this week condemned the administration’s decision to slash the number of diseases that U.S. children are vaccinated against.
“The American Medical Association applauds the administration’s new Dietary Guidelines for spotlighting the highly processed foods, sugar-sweetened beverages, and excess sodium that fuel heart disease, diabetes, obesity, and other chronic illnesses,” AMA president Bobby Mukkamala said in a statement.
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