(Reuters) - - U.S. Surgeon General Vivek Murthy issued an advisory on Friday calling for alcoholic drinks to carry a label that warns consumers about their cancer risks.

Following are key recommendations and conclusions of fact contained in the 21-page advisory, along with page references.

Key recommendations

* Update the existing surgeon general's health warning labelon alcoholic beverages to include a warning about the risk ofcancer associated with alcohol consumption (Page 17). * Reassess recommended limits for alcohol consumption toaccount for the latest evidence on alcohol consumption andcancer risk (Page 16). * Strengthen and expand education efforts to increasegeneral awareness that alcohol consumption causes cancer (Page16). * Inform patients in clinical settings about the linkbetween alcohol consumption and increased cancer risk (Page 16). * Highlight alcohol consumption as a leading modifiablecancer risk factor and incorporate proven alcohol reductionstrategies into population-level cancer prevention initiativesand plans (Page 16).Factual Conclusions

* Alcohol consumption is the third leading preventable causeof cancer in the United States, contributing to nearly 100,000cancer cases and about 20,000 cancer deaths each year (Page 3). * Scientific evidence demonstrates a causal relationshipbetween alcohol use and increased risk for at least sevendifferent types of cancer, including breast (in women),colorectum, esophagus, liver, mouth, throat, and voice box (Page3). * The risk of cancer increases with the level of alcoholconsumption, with higher risk at higher levels of consumption.For certain cancers, like breast, mouth, and throat cancers,evidence shows that this risk may start to increase around oneor fewer drinks per day (Page 12). * Alcohol breaks down into acetaldehyde in the body, ametabolite that causes cancer by binding to DNA and damaging it.When DNA is damaged, a cell can begin to grow uncontrollably andcreate a cancerous tumor. (Page 10) * Alcohol generates reactive oxygen species, which increaseinflammation and can damage DNA, proteins, and lipids in thebody through a process called oxidation. * Alcohol alters hormone levels (including estrogen), whichcan play a role in the development of breast cancer. * Carcinogens from other sources, especially particles oftobacco smoke, can dissolve in alcohol, making it easier forthem to be absorbed into the body, increasing the risk for mouthand throat cancers. * The International Agency for Research on Cancer classifiesalcohol as a Group 1 carcinogen, the highest level ofclassification for substances that can cause cancer in humans,alongside tobacco, asbestos, and formaldehyde, among others(Page 8).

(Editing by Mark Bendeich and Susan Fenton)