Before you order another round, consider this: “All types of alcoholic beverages, including wine, increase cancer risk,” says Andrew Seidenberg, PhD, MPH, a researcher with the National Cancer Institute (NCI). Most Americans aren’t aware of this link, he and his team found in a recent study. What’s more, many incorrectly thought beer and hard liquor presented a cancer risk but not wine.

Each year, about 75,000 cancer cases and 19,000 cancer deaths are estimated to be linked to alcohol in the United States, according to the NCI. Worldwide, about 4% of cancer cases in 2020 were associated with alcohol.

Alcohol causes cancer because it contains ethanol, which is a carcinogen that can damage DNA, increase estrogen (known to promote breast cancer) and cause esophageal, mouth and throat and liver cancers. (Of note, a separate study found that abstaining from alcohol improves outcomes for folks with alcohol-related cirrhosis, or scarring of the liver, which shows it’s never too late to cut back on the booze.)

The emergence of the COVID-19 pandemic caused many Americans to consume more alcohol, so it’s even more vital now to raise awareness that it can cause cancer.