MIAMI — Cancer deaths attributed to alcohol in the United States roughly doubled between 1990 and 2023, and among adults ages 20 to 54 the leading killers were not liver tumors, researchers reported.

The analysis, published in The Lancet Regional Health — Americas and led by physicians at the University of Miami’s Sylvester Comprehensive Cancer Center, estimated 23,126 alcohol-attributable cancer deaths in 2023, up from 11,361 in 1990. Men accounted for 17,477 of the later total. The work drew on more than three decades of Global Burden of Disease data.

“The most surprising finding was the breadth of alcohol’s potential impact across cancer types,” said Chinmay Jani, corresponding author and chief fellow in hematology and oncology at Sylvester. “Although its relationship with liver cancer is widely recognized, its contribution to cancers such as colorectal, esophageal, breast, pancreatic and prostate cancer is less well understood by the public.”

That gap is sharpest under age 55. “Notably, among adults aged 20 to 54, colorectal cancer was the leading cause of alcohol-attributable cancer mortality in men and the second leading cause in women, surpassing liver cancer in both groups,” Jani said. For women in that age band, breast cancer ranked first and colorectal second. Esophageal cancer followed colorectal among younger men. Liver cancer sat below both in each sex.

The raw death rate in ages 20 to 54 was unchanged at 2.4 per 100,000 from 1990 to 2023. What changed was alcohol’s share. The percentage of cancer mortality attributed to drinking in that group rose from 4.5% to 6.6%. Among people 55 and older, the age-standardized rate climbed from 15.8 to 19.2 per 100,000, and alcohol’s share rose from 1.7% to 3.0%.

“Even though overall the cancer mortality was going down for some of these cancers … alcohol associated mortality was going up,” Jani told The Washington Post. “Which means that alcohol as a risk factor was impacting more cancer deaths in 2023 than it was in 1990.” He told MedPage Today the same pattern held “for both males and females, and for the younger and elderly population as well.” “For the younger population, cancer mortality from colorectal cancer has taken over from liver cancer, especially among males, which is concerning,” he said.

Among older men, liver cancer still produced the highest alcohol-linked death rates, then esophageal and colorectal cancers. Among women of all ages, breast cancer was the leading alcohol-attributable cancer death. The study found rising alcohol shares across most tumor types except liver cancer in some older groups. The largest proportional jumps included stomach, pancreatic and colorectal cancers.

The International Agency for Research on Cancer classifies alcoholic beverages as a Group 1 carcinogen. Ethanol and its metabolite acetaldehyde can damage DNA, raise estrogen and promote inflammation. Public surveys still show limited awareness of that list beyond the liver.

The estimates are modeled, not death-certificate counts that list “alcohol” as the cause. They apply population drinking patterns and established risk ratios to cancer mortality. That method can miss binge patterns, underreporting and other overlapping risks such as obesity and smoking. It cannot prove that any single patient’s tumor was caused by drinking. State rates varied: the District of Columbia was highest and Utah lowest in the paper’s maps.

An earlier version of the analysis, using data through 2021, was presented at the American Society of Clinical Oncology meeting. Gilberto Lopes, Sylvester’s chief of medical oncology, co-led the work.

The clinical implication is screening, not slogans. Early-onset colorectal cancer has been rising in the United States for years. Breast cancer remains the most common cancer in younger women. Neither is framed in most public-health ads as an alcohol disease. Jani’s tables say that, among drinkers who die of cancer before 55, those two sites now outrank the organ people picture when they cut back.

The study does not prescribe a safe number of drinks. It does say the death count tied to alcohol is larger than it was a generation ago, that men and older adults still carry most of it, and that the mix under 55 has shifted toward the colon, rectum and breast. Physicians who ask only about the liver are asking the wrong first question.

Picture a city with 75,000 people, its own grocery stores, movie theatres, and swimming pools. Now imagine that city was invisible. No road signs pointed to it. No state map showed it. If you asked a local where it was, they legally couldn’t tell you, because most of them didn’t fully know either. This isn’t fiction. It’s Oak Ridge, Tennessee, and it was one of the strangest, most audacious secrets the U.S. government has ever pulled off.

A City That “Didn’t Exist”

When Japan attacked Pearl Harbor in December 1941, Oak Ridge didn’t exist at all. There was no city, no name, nothing but quiet farmland tucked into the valleys of East Tennessee.

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Then, in 1942, the US government quietly began buying up roughly 60,000 acres of that farmland ‘on land framed by the foothills of the Appalachian Mountains’. Families who had lived there for generations were told to pack up and leave, often with only a few weeks’ notice, no explanation given, and no say in the matter.

By July 1943, the takeover became official. An army captain handed Tennessee’s governor a proclamation, straight from President Franklin Roosevelt, declaring the land a total exclusion area no longer under state control. The governor reportedly tore it up on the spot. It didn’t matter. The federal government now controlled the land, no questions asked.

Why This Sleepy Valley?

The location wasn’t chosen by accident. Oak Ridge sat far from either coast, making it an unlikely bombing target, and its valleys offered natural cover, plus room to separate massive industrial plants in case something went catastrophically wrong.
It was also cheap and remote, sparsely populated, which meant fewer people to notice, and fewer people to ask questions. Within months, this “nowhere” spot became one of three secret sites, alongside Los Alamos, New Mexico, and Hanford, Washington, chosen to build the world’s first atomic bomb as part of the Manhattan Project.

Life Behind the Fence

What rose out of that Tennessee mud was almost unbelievable. By its peak, Oak Ridge was home to ‘75,000 people, making it the fifth-largest city in Tennessee’, bigger than many cities that actually appeared on maps.

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And yet, officially, it was blank space. Guards stood at every entrance. Every resident wore a badge at all times. Access required special approval, and visitors were essentially banned. Locals in nearby Knoxville reportedly knew something odd was happening, Oak Ridge workers were recognizable by their mud-caked shoes, a giveaway of the town no one was supposed to talk about.

Inside the fence, life looked almost normal, grocery stores, dances, churches, swimming pools. But almost nobody living there understood the true purpose of their own jobs. Workers were given fragments of tasks with zero context, deliberately kept in the dark so that even if information leaked, it wouldn’t add up to anything useful. One young chemist who arrived in 1943 later recalled being warned never to say the word “uranium” again after his very first day.

Some estimates suggest Oak Ridge briefly used more electricity than New York City, largely to power the massive uranium enrichment plants humming day and night behind the checkpoints.

When the Secret Finally Came Out

The truth broke in August 1945, when the U.S. dropped atomic bombs on Hiroshima and Nagasaki. Only then did the outside world, and most of Oak Ridge’s own residents, learn what they’d actually built: the enriched uranium used in the first atomic weapon ever deployed in war.

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Even after that, Oak Ridge stayed a closed, gated city for years. It wasn’t until March 1949 that its roads finally opened to the public, ending seven years of total secrecy.

What’s Left Today

Oak Ridge is no longer hidden, it’s a real, mapped city near Knoxville, and part of it is now preserved as the Manhattan Project National Historical Park. Visitors can tour surviving facilities, ride a scenic train along old supply routes, and see remnants of the plants that once ran around the clock behind armed checkpoints.

It remains one of the most remarkable facts of American history: for seven years, tens of thousands of people lived, worked, and raised families in a city the federal government built from nothing, and then simply erased from every map in the country.

WASHINGTON – President Donald Trump said Thursday that a deal has been reached for Hamas to disarm and Israel to withdraw its forces from Gaza, but many hurdles, conditions and long timelines remained to wind down the war in the Palestinian territory. Neither Hamas nor Israel gave immediate indication that they had agreed.

The White House announcement comes nine months after a U.S.-brokered ceasefire was signed. Negotiations between Israel and Hamas had largely deadlocked over the implementation of its second phase, including the disarmament of Hamas and the reconstruction of Gaza.

“The agreement will be carried out in carefully structured phases,” Trump said on social media. “As disarmament is completed, Israeli forces will withdraw, and the International Stabilization Force will work with a new Palestinian police force to take responsibility for Gaza being safe for its residents and its neighbors.”

Trump’s 20-point ceasefire plan calls on the Iran-backed militant group to surrender its weapons and destroy its vast network of tunnels. It also envisions Israeli forces withdrawing from Gaza, the arrival of a new technocratic Palestinian government, deployment of an international security force and the rebuilding of the battered Palestinian enclave after more than two years of war.

But Hamas had insisted on implementing the first phase before moving to discuss its weapons. The group’s founding charter calls for armed resistance against Israel, and it has been reluctant to give up an arsenal, including rockets, anti-tank missiles and explosives, that lies at the heart of its identity.

Hamas announced earlier this month that it had dissolved its government in Gaza and was preparing to transfer power to a technical committee backed by the United Nations as part of the ceasefire deal.
U.S. and Board of Peace officials, describing the deal to reporters on condition of anonymity under guidelines set by the White House, gave an extremely optimistic assessment of the agreement that laid out a scenario very similar to the one described by Trump and his top aides when the Board of Peace, an international body established by Trump to oversee the ceasefire in Gaza, was first formed.The officials were unable to offer specific timelines for the disarmament of Hamas or other groups that operate in Gaza such as Palestinian Islamic Jihad, but said the Gaza police force would turn over weapons to the technocratic Board of Peace-backed Gaza administration in the next two weeks.

The Gaza police force, however, does not include the vast majority of Hamas militants and heavy weaponry is not included in that part of the agreement, according to the officials.

Instead, the surrender of heavy weapons and the decommissioning of Hamas tunnels and other infrastructure are to come later in a process that could take between 200 and 350 days, a Board of Peace official said.

A U.S. official said that Israel, which has been deeply skeptical about Hamas’ willingness to give up its guns or relinquish at least behind-the-scenes control of Gaza, had been consulted at every step of the negotiation.

However, the official said Israel was not being asked to do anything more than what it had initially committed to when it agreed to Trump’s 20-point plan, which essentially involves withdrawing its forces from Gaza and committing to ending airstrikes on the territory.

Israel’s U.N. Mission said it had no immediate comment.

The official added that Hamas sponsor Iran remains a wildcard in the equation because although it counseled Hamas members not to accept a deal, it is also not in a position to offer the group much support because it is preoccupied with the conflict with the United States.

The war in Gaza began after the Hamas-led attack on southern Israel on Oct. 7, 2023, killed around 1,200 people and saw 251 taken hostage. Israel’s retaliatory offensive in Gaza has killed more than 73,000 Palestinians, including those killed since the ceasefire, Gaza’s Health Ministry said.

Israel’s military now controls more than half of Gaza, leaving Palestinians confined to squalid tent camps and heavily damaged urban neighborhoods.