What are Iowa lawmakers doing about soaring cancer rates?

DES MOINES — Among the issues Iowa lawmakers are aiming to address this legislative session, one has become a clear focal point: the state’s increasing cancer rate.

Iowa has the fastest-growing rate of new cancers in the nation and ranks second-highest in cancer rates — behind Kentucky — compared with other states, according to the Iowa Cancer Registry. The state’s cancer incidence rate has increased in each of the last three five-year reporting periods.

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Gov. Kim Reynolds highlighted the landscape of the disease in Iowa during her Condition of the State address in January, where she asked for a $1 million investment in research by the Iowa Department of Health and Human Services and the University of Iowa looking at the behavioral, genetic and environmental factors that might be contributing to the state’s cancer rates.

Reynolds’ husband, Kevin, has been undergoing treatment for lung cancer and she announced during her address that his cancer is in remission.

Reynolds noted that Iowa has one of the highest rates of alcohol-related cancers. Iowa ranks fourth-highest in the nation for binge drinking in 2022, according to the Iowa Cancer Registry.

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Mary Charlton, director of the Iowa Cancer Registry, said the most common cancers in Iowa are prostate cancer, breast cancer, lung cancer, colorectal cancer and melanoma.

While alcohol is one of the leading causes of cancer in the state, it’s not the main explanation for Iowa’s cancer rate, according to Charlton.

“I use the analogy of the Trivial Pursuit game, the little wheel,” Charlton said. “Cancer is like that game piece. And when you fill in all the pieces of the pie, you get cancer. There's a lot of pieces of the pie that you can't do anything about. They get filled in for you, like your genetics and whether you're a male or female, or even, to an extent, where you live and your age, things like that are harder to modify, but alcohol is one that's easier to modify.”

Charlton said some of the most effective forms of legislation lawmakers could bring forward are bills addressing controllable risk factors of cancer, including increasing the cigarette tax and incentivizing healthy lifestyles.

Here’s the legislation lawmakers are looking that concerns cancer:

Regulating tanning bed use for minors

House File 116 would prohibit tanning facilities from allowing minors to use tanning devices. Bill sponsor Rep. Hans Wilz, R-Ottumwa, said this legislation is just one piece of addressing Iowa’s cancer rates.

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“This is not going to be fixed in one year,” Wilz said. “This is going to take some time, but I do believe the attention has been brought to it, and people are starting to understand there are some simple things like radon mitigation and avoiding cancer-causing things like sun tanning beds that are easy, I think they’re common sense.”

According to the American Academy of Dermatology, using tanning beds before age 20 can increase the chances of a person developing melanoma by 47 percent.

Iowa has a similar melanoma rate to Sun Belt states like Arizona or Florida, according to the Iowa Cancer Registry.

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Rep. Austin Baeth, D-Des Moines, said limiting the access minors have to tanning devices is a good start to tackling Iowa’s melanoma rates. He noted that 44 states have some sort of legislation restricting minors’ use of tanning beds, and Iowa is one of the six states without any sort of law requiring parental consent.

“One of the, in my opinion, biggest pieces of low-hanging fruit is to ban minors from indoor tanning beds,” Baeth said. “This is no different than allowing 14-year-olds to smoke or to drink. This is just as dangerous, and yet we don't have any guardrails in place to protect our youth.”

In 2015, the Iowa Senate passed a ban on minors using tanning beds, but it did not pass in the House.

Radon mitigation

There are multiple bills in the Legislature aiming to mitigate radon in homes and apartments. Radon is a radioactive gas that can enter residences through floors, walls and foundations, but is most concentrated in basements and lower levels of buildings. Exposure to it is a leading cause of lung cancer among non-smokers, according to the U.S. Environmental Protection Agency.

The average indoor radon concentration in Iowa was six times higher than the national average, placing Iowa with the highest average radon level of any other state in 2023, according to the Iowa public health officials.

House File 377, introduced by Wilz, would place more requirements for radon testing in residential buildings. Under the legislation, a tenant could terminate a lease without facing repercussions if a landlord fails to have a radon mitigation system installed.

Another bill, House File 211 introduced by Rep. Skyler Wheeler, R-Hull, would create a tax credit for installing radon mitigation systems or testing for radon.

Addressing medical debt for cancer patients

Lawmakers potentially will consider legislation that would cap interest on medical debt for cancer patients. Although bills for this issue have yet to be introduced, lawmakers are looking to bring one forward this session.

Jackie Cale, a government relations director for the American Cancer Society, said she has had conversations with members of the House Health and Human Services and Commerce committees about a bill that would potentially cap interest on this medical debt.

It's estimated that 47 percent of cancer patients and survivors have incurred medical debt in order to pay for their cancer care, with many of them postponing treatment to avoid incurring more debt, according to Cale.

Shari Randol is one Iowan who considered pausing cancer treatment. Randol stopped working after she was diagnosed with non-Hodgkin's lymphoma, in 2024. Losing her job also meant losing her insurance, and she has been in debt ever since because of high interest rates.

“I considered for quite a while stopping treatment, just so there would be no new medical bills of brewing, and then maybe I could get the old ones paid off in due time,” Randol said. “I thought about that for several weeks, but I kept on going. I wanted to live.

“It feels like you’re just being swallowed up.”

Reynolds announced a Medicaid work requirement during her Condition of the State address. Currently, Medicaid eligibility in Iowa is based on income and whether a person has a disability, but a Medicaid work requirement would require that recipients who are able-bodied adults need to work to receive benefits.

Shield law for pesticide manufacturers

While many of the measures look at reducing cancer rates or helping cancer patients, advocates say others could worsen the situation.

One bill would protect agriculture chemical companies from lawsuits over warning labeling on their products to inform consumers of the health risks of the product, including cancer, under legislation being considered by Iowa lawmakers.

Senate Study Bill 1051, which was advanced out of the Senate Judiciary Subcommittee this month, would shield agriculture chemical manufacturer Bayer from lawsuits claiming the company failed to warn consumers of health risks if the product label complies with federal labeling requirements.

Food and Water Watch held a rally last week in the Capitol Rotunda where attendees urged lawmakers to oppose the bill, which they refer to as the “cancer gag act.”

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Bayer argues that since the U.S. Environmental Protection Agency has determined glyphosate is not carcinogenic, the company should not be required to put cancer warnings on the weedkiller Roundup.

Although the EPA has cleared glyphosate of posing cancer risks, a federal district court requested that the agency review that decision in 2022, according to Reuters. The International Agency for Research on Cancer determined it is "probably carcinogenic to humans."

Some farmers have expressed concern that if the bill doesn’t pass, their access to pesticides like Roundup would be restricted.

Baeth said the bill is “tone deaf” when lawmakers of both parties are working to address Iowa’s cancer rates.

“It is never the right time for these bills, but for our particular state at this particular time, they’re just dead wrong,” he said.

Minors' ability to consent to HPV vaccine

Iowa lawmakers also are considering a bill that would remove a minor’s ability to legally consent alone to receiving the HPV vaccine.

Senate File 120 would take away a minor’s legal capacity to consent to receiving a vaccine without parental approval. The legislation is specifically aimed at the HPV vaccine or vaccines used to treat sexually transmitted diseases or infections.

HPV is a viral infection that is most commonly transmitted sexually and can cause some forms of cancer. The vaccine has the potential to prevent more than 90 percent of HPV-caused cancers, according to the U.S. Centers for Disease Control and Prevention.

The Iowa Senate Health and Human Services Subcommittee advanced Senate File 120 in February. A similar bill was introduced in the Iowa Senate last year.

Supporters of the legislation argue the current policy allows for minors to be coerced into accepting a vaccine and the proposed legislation would return a layer of parental choice.

But representatives of medical associations and medical professionals say the bill would backslide efforts to reduce Iowa’s cancer rates.

“We know that the HPV vaccine is cancer prevention, and we feel that is a large step backward in Iowa’s fight against cancer, and Iowa’s rising cancer rates,” Cale said.