Escalating impact of alcohol-related cancer mortality in the US: A call for action.

10519 Background: Alcohol consumption is known to be a significant risk factor for cancer. This year, the US Surgeon General recommended adding cancer risk warning labels to alcoholic beverages, emphasizing the need for increased awareness. However, data on its impact on individual cancer mortality remains limited. This study aims to evaluate trends in alcohol-associated cancer mortality in the US utilizing Global Burden of Disease (GBD) database. Methods: We utilized data from the GBD to analyze absolute and proportional Age-Standardized Mortality Rates (ASMR) attributable to heavy alcohol use—defined as consumption exceeding the theoretical minimum risk exposure level—in the US from 1990 to 2021. We evaluated ASMR for all cancers combined, followed by specific cancers, including esophageal, liver, laryngeal, breast, colorectal, lip-oral cavity, nasopharyngeal, and other (oro/hypo) pharyngeal. Results were reported per 100,000 population and stratified by gender, state, and age groups (20–54, 55+). Estimated Annual Percentage Change (EAPC) was calculated using JoinPoint regression analysis. Results: Alcohol-associated cancer deaths in the U.S. doubled from 1990 (11,896) to 2021 (23,207). The 55+ age group showed a significantly higher ASMR than the 20-54 age group (Table 1). Proportional alcohol-associated ASMR increased for all cancers and individual cancers across both age groups and genders, except for liver cancer in 55+ age group. In 2021, for 55+ age, liver cancer had the highest alcohol-associated proportional ASMR in males (38.5%), followed by nasopharyngeal cancer (31.8%), while in females, nasopharyngeal (18.9%) and oro/hypopharyngeal cancers (18.4%) ranked highest. In 20-54 age, lip-oral cavity cancer had the highest alcohol-associated proportional ASMR for both genders (m:41.8%; f:26.9%). In 2021, the District of Columbia had the highest alcohol-associated all-cancer ASMR (m:10.0; f:3.6) followed by Texas (7.5) for males and New Hampshire for females (2.9). In contrast, Utah had the lowest (m:3.5; f:1.4). On evaluating trends, a constant increase was observed in alcohol-associated ASMR for 55+ age group for males (EAPC 0.5, 2008-2021) and females (EAPC 1.1, 2006-2021). Conclusions: Alcohol-associated cancer mortality has significantly increased in the U.S. over the past three decades, with a disproportionate burden observed in males and individuals aged 55 and older. Our findings highlight the critical need for targeted prevention efforts, public health policies, and increased awareness to address the rising impact of alcohol consumption on cancer-related mortality across different demographic groups and regions. Alcohol associated-all cancer ASMR. Age(n=Absolute, %= Proportional) Male - 1990 Male - 2021 Female - 1990 Female -2021 Overall 5.7 (0.03%) 6.2 (0.04%) 2.6 (0.02%) 2.2 (0.02%) 20-54 2.2 (4.3%) 2.4 (6.8%) 1.8 (3.3%) 1.4 (3.6%) 55+ 27.3 (2.4%) 31.7 (4.3%) 10.7 (1.5%) 10.4 (1.9%)