By Danielle 
Heavy alcohol consumption has sharply increased the global burden of lip and oral cavity cancers over the past three decades, with the steepest rise seen in Southeast Asia and in lower-middle SDI regions, according to a new analysis based on Global Burden of Disease 2021 data provisionally accepted for publication in Frontiers on Sept. 15.
The authors report that disability-adjusted life years (DALYs) attributable to alcohol-related lip and oral cavity cancers reached 1,191,084 in 2021, up from 628,484 in 1990 — an increase of about 90 per cent over the period.
Explainer: What is SDI: The SDI reflects the average education level of a country’s population aged 15 and above, lagging income distribution per capita, and fertility rate under 25 years old, which adequately reflects the degree of development of a country; it ranges from 0 (worst) to 1 (best). All regions were divided into five levels according to SDI: high SDI (HSDI), high-middle SDI (HMSDI), middle SDI (MSDI), low-middle SDI (LMSDI), and low SDI (LSDI).
Southeast Asia and men most at risk
Southeast Asia recorded the sharpest increases, with DALYs up 326% and deaths up 357% since 1990. Central Europe posted the highest age-standardized DALY rates in 2021, while Southeast Asia experienced the fastest growth.
Men were disproportionately affected. Peak burden occurred at ages 55–59 in men and 60–64 in women.
Aging and population growth drive the rise
Most of the global increase was explained by population aging and growth, though epidemiological changes also contributed.
“Over the past 32 years, population growth and aging have been the primary drivers of rising DALYs and deaths,” the authors wrote.
The authors project that from 2022 to 2045 the burden will continue to climb, especially among men.
The study team, led by Suzhou Stomatological Hospital in China, urges targeted action in low- and middle-income countries: lifestyle interventions, earlier screening and optimized resource allocation to curb future burden.
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Alcohol consumption trends
Industry data from IWSR indicate that alcohol market growth is increasingly driven by emerging economies, with India’s total beverage alcohol (TBA) volumes rising by about 4 per cent in the first half of 2024, alongside strong gains in parts of Southeast Asia and Africa.
In Canada, Statistics Canada reports that in 2023 a higher share of 18- to 22-year-olds reported no alcohol in the past seven days (67%) versus 51%–57% in other age groups — consistent with moderation among younger adults.
In the United States, a 2025 Gallup survey found a record-low 54% of adults say they drink alcohol, amid rising concern that even moderate drinking is unhealthy. Recently, the Department of Health and Human Services withdrew a draft government report warning of cancer links from even low levels of alcohol consumption.
Related: U.S. health department pulls back study tying alcohol to oral, esophageal and other cancers
Meanwhile, the World Health Organization classifies alcohol as an established carcinogen and estimates that in 2019 alcohol caused 2.6 million deaths worldwide, with men accounting for about 2.0 million and women 0.6 million. In the same year, 4.4% of cancers diagnosed globally and 401,000 cancer deaths were attributable to alcohol consumption.