(Radio Iowa) – Iowa’s cancer rate is the second worst in the nation for three years running, and a comprehensive study being released today (Friday) offers little optimism. The 2026 Cancer in Iowa Report predicts some 21-thousand-700 Iowans will be diagnosed with invasive cancers this year, and 64-hundred Iowans will die from cancer. Both figures are up from last year’s report. Mary Charlton is an epidemiology professor at the University of Iowa and director of the Iowa Cancer Registry. While many states are seeing cancer rates fall, Charlton couldn’t pinpoint why Iowa’s numbers are rising. “It’s hard to say because the risk factors that are causing the cancers now are things that could have happened 10, 15, 20 years ago,” Charlton says. “So it’s going to take a while to really turn things around and it’ll probably take some really strong new policies and new approaches in Iowa to turn things around.”

A symposium on cancer prevention and treatment this week at Drake University, featured an expert on nitrate poisoning in waterways, which has been a years-long battle in Iowa. Charlton says nitrates may be one cancer culprit. “It certainly could be a contributing factor. I think there’s a lot of things at play. Cancer is really complicated. It’s just a complex interplay of genetic, lifestyle, and environmental risk factors working all together,” Charlton says. “There’s not one thing causing it, but there’s probably lots of things contributing to it. Nitrate could certainly be one of those things.” One bright spot in the report deals with farm families. Iowa farmers in a recent study had 13-percent fewer cancers overall than expected compared to Iowa’s general population, and their spouses had ten-percent fewer.

“The farmers in the Agricultural Health Study had lower smoking and drinking rates compared to the rest of the general population in Iowa,” Charlton says. “They also talk about something called the healthy worker effect. So to be in their study, to be a farmer that was enrolled in the Agricultural Health Study, you have to be healthy enough to be a farmer — so those are a couple of things.” The report found the rate of new cancers in young adults in Iowa for 2018-2022 is higher than the rate for 2008-2012, and is the second highest in the nation. Also, compared to the 2025 edition of the report, Charlton says Iowa’s most common types of cancer haven’t changed.

“Same story, different year,” she says. “We still have breast, prostate, lung and colorectal cancers, followed by melanoma. They make up over half of our cancer cases in Iowa. Unfortunately, lung cancer continues to be the most common cause of cancer deaths, accounting for nearly one out of every four cancer deaths in Iowa, followed by colorectal and pancreatic cancers.” The report says the state’s number of cancer survivors is increasing, with an estimated 175,290 survivors now living in Iowa.

https://shri.public-health.uiowa.edu/cancer-data/iowa-cancer-reports/