Cancer is falling nationwide, Except in Iowa

Aerial view of a farm with red barns and expansive green and brown fields — Photo: Lena Platonova / Shutterstock

Cancer rates are falling almost everywhere in America, but in Iowa, they just keep climbing.

Quick Take

Iowa now ranks second in the nation for new cancer cases and is one of only a few states where the rate is still rising.
The state’s cancer rate was dropping along with the national trend until around 2013, when it suddenly reversed course.
The 2026 Cancer in Iowa report predicts over 21,000 new diagnoses and thousands of deaths this year alone.
Researchers and state health officials are now studying behavior, environment, and genetics to find out why.

A State Bucking The National Trend

Cancer has been retreating across the United States for years. Better screening, fewer smokers, and improved treatments have pushed national incidence rates steadily downward. Iowa tells a different story. The state now sits second in the country for new cancer diagnoses and remains one of only a few states where the rate is actually climbing instead of falling.

Federal data back up what Iowa’s own researchers have found. National incidence sits around 448.6 cases per 100,000 people and is falling. Iowa’s rate is nearly 499 per 100,000 and rising by about 0.7 percent a year, according to the National Cancer Institute’s state tracking database. That gap has widened enough to turn a public health statistic into a dinner-table worry for thousands of Iowa families.

The 2013 Turning Point

For decades, Iowa’s cancer numbers moved in step with the rest of the country, both trending downward. That changed around 2013, when Iowa’s rate suddenly spiked while the national rate kept sliding. Reuters reported the shift became measurable the following year and has not reversed since, with Iowa holding the nation’s second-highest cancer rate every year since 2023. Health officials still have not pinned down a single cause for the break.

The divide is not just about overall numbers. University of Iowa researchers found the state’s rate of new cancers in children and teens looks similar to the rest of the country. But young adults in Iowa are being diagnosed at significantly higher rates than young adults nationwide. That detail has fueled concern among parents and doctors watching diagnoses creep into younger populations.

What The Newest Numbers Show

The 2026 Cancer in Iowa report, produced by the Iowa Cancer Registry, projects roughly 21,700 Iowans will be diagnosed with invasive cancer this year, and about 6,400 will die from the disease. More than half of Iowa’s counties report incidence rates above the national average, and none fall below it, according to a state update on the issue. The report also found Iowa averaged about 2,001 more diagnoses per year among adults than researchers would expect based on national patterns.

Searching For A Cause

Iowa’s Department of Health and Human Services has partnered with the University of Iowa College of Public Health to dig into possible explanations, looking at behavioral habits, environmental exposures, and genetic factors. Cancer rates naturally vary by state, and the American Cancer Society notes the biggest swings usually involve cancers tied to preventable exposures, especially lung cancer linked to smoking history. That context matters, but it does not fully explain why Iowa alone broke from a downward national trend that held steady for over a decade.

Not every analysis points toward alarm. One independent review of Iowa’s long-term data found the state’s overall age-adjusted incidence has stayed nearly flat since 1999, and argued that when diagnoses rise faster than deaths, better screening and earlier detection are often the real driver rather than a new environmental threat. That is a reasonable, data-grounded counterpoint worth weighing alongside the registry’s findings, even as the state’s own numbers show Iowa pulling away from the national curve.

Whatever the final answer turns out to be, Iowa families are not waiting quietly for it. The issue has already become a talking point in the state’s upcoming midterm races, with candidates and advocacy groups pointing to rising diagnoses as proof that Washington and state leaders need to move faster on answers. For a state built on farmland and small towns, a cancer trend running opposite the rest of the country is the kind of problem that does not stay confined to a lab report for long.