Alcohol consumption and cancer progression: Mechanistic insights, immune dysregulation, and public health implications

A review article published in the journal Transitional Oncology states that alcohol consumption is a modifiable, dose-dependent risk factor that accelerates cancer initiation, progression, and therapy resistance across breast, liver, colorectal, oesophageal, and melanoma cancers.
According to the authors, alcohol metabolism generates acetaldehyde, a genotoxic metabolite that induces DNA damage and impairs repair; drives oxidative stress and hormonal imbalance, and promotes a tumour-supportive microenvironment. These effects are amplified by obesity and insulin resistance, which heighten aggressiveness and blunt treatment response. Alcohol can alter the tumour microenvironment in ways that help cancer grow and make treatments less effective. It weakens the body’s immune response by reducing the ability of immune cells to recognise and attack cancer cells, while increasing the number of cells that suppress immune activity.
Alcohol also promotes ongoing inflammation and oxidative stress, which can create conditions that allow tumours to thrive. In addition, it alters the structure of tissues and blood vessels around tumours, making it harder for immune cells and cancer treatments to reach and destroy cancer cells. As a result, alcohol may reduce the effectiveness of immunotherapy, targeted therapies, and chemotherapy.
Alcohol can also disrupt the balance of bacteria in the gut, which is important for a healthy immune system and may influence how well cancer immunotherapies work. Furthermore, alcohol increases the release of tiny particles called exosomes into the bloodstream. These particles carry molecular signals that can alter immune function, encourage cancer spread, and contribute to treatment resistance. Together, these effects suggest that alcohol can create conditions that help cancers evade the immune system and become harder to treat.
The cancer risk associated with alcohol is even greater when combined with smoking, and it increases with age as the body’s ability to remove harmful substances and repair DNA damage becomes less effective. Women may be particularly vulnerable because they process alcohol differently and generally have body compositions that can lead to greater alcohol exposure.
Social and economic challenges can also delay cancer diagnosis and access to treatment, increasing the risk of poorer outcomes. To reduce alcohol-related cancer risk, prevention efforts should focus on reducing alcohol consumption, helping people quit smoking, and improving nutrition. Researchers are also exploring new biological markers, such as substances found in the blood that are linked to alcohol use, which may help identify people at higher risk and detect cancer earlier.
Although alcohol is known to increase cancer risk, more research is needed to fully understand how it affects the success of treatments such as immunotherapy and chemotherapy. Nevertheless, reducing alcohol use remains an important strategy for lowering cancer risk and improving overall health.
Source: Deshpande, R.P., Tyagi, A., & Watabe, K. (2026) Alcohol consumption and cancer progression: Mechanistic insights, immune dysregulation, and public health implications. Translational Oncology, 68, 102793.