US Surgeon General Vivek Murthy said alcohol consumption increased the risk of at least seven types of cancer, including breast, colon and liver cancer, but most US consumers remained unaware of the consequences.
Murthy also called for the guidelines on alcohol consumption limits to be reassessed so people can weigh the cancer risk when deciding whether or how much to drink.
US dietary guidelines currently recommend two or fewer drinks per day for men and one drink or less per day for women.
"Alcohol consumption is the third leading preventable cause of cancer in the United States, after tobacco and obesity," Murthy's office said in a statement accompanying the new report, adding the type of alcohol consumed does not matter.
Alcohol increases the risk of many types of cancer including breast, colon and liver cancer. (Daniel Munoz/AAP PHOTOS)
His advisory sent shares in alcohol companies including Diageo, Pernod Ricard, Anheuser-Busch InBev and Heineken down, in some cases over 3 per cent.
It is unclear when or if the Surgeon General's suggestions will be adopted.
US President Joe Biden's administration is ending. Murthy could be succeeded by Janette Nesheiwat, a director of a New York chain of urgent care clinics and president-elect Donald Trump's pick for the role.
Trump, whose brother died from alcoholism and who does not drink himself, has long warned about the risks of alcohol.
Robert F Kennedy Jr, Trump's nominee for Secretary of Health and Human Services, has been open about his past struggles with heroin and alcohol, and says he attends Alcoholics Anonymous meetings.
The decision to update labels will ultimately be made by Congress.
Murthy's advisory harks back to early US Surgeon General action on tobacco, starting with a 1964 report that concluded smoking could cause cancer.Â
The report kicked off decades of increasingly strict regulations, starting with US laws on warning labels one year later and still ongoing today.
Alcoholic drinks in the US already carry warnings on packaging, including that drinking alcohol while pregnant can cause birth defects and impair judgment when operating machinery.
These appear in small print on the back of the packaging. This label has not changed since its inception in 1988.
Murthy's recommendations call for an update to existing labels, rather than new cigarette-style warnings that are displayed prominently on every packet.
In the US, among the largest markets for many western producers, alcohol sales have been falling following a post-pandemic boom.
Longer-term, companies face competition from alternatives like cannabis and the threat of lower volumes as some consumers, especially younger ones, drink less than previous generations in some markets.
Public health bodies like the World Health Organization are also increasingly turning their attention toward alcohol after making progress on stronger tobacco controls.
The WHO says there is no safe level of drinking and that even a small amount of alcohol can harm health - a position that has prompted tense debate around the impact of moderate drinking and its role in society.
