Cancer in Iowa report to start including pediatric rates

IOWA CITY — The oft-cited Cancer in Iowa report that for several years has found the state to have the second-highest and fastest-growing rate of new cancers in the nation next year will start breaking out pediatric numbers.

“Up until now, they have not had a focused issue on children — until next year,” University of Iowa pediatric hematologist-oncologist David Dickens said. “So next year's report is going to have at least a page which is going to break out children and ask the question, how is Iowa doing relative to the rest of the country?”

Dickens shared those plans Wednesday during The Gazette’s Iowa Ideas in-depth week on cancer, reporting that researchers have just started looking at the pediatric cancer-rate data in preparation for next year’s report.

“And I think the answer is sometimes it's the same problem and sometimes it's not,” he said of Iowa’s high numbers.

For smaller children, those 14 or younger, Iowa sits around the national average for cancer rates — not significantly better or worse than the rest of the country.

“In older adolescents and young adults, it looks like that's where the incidence rates are starting to rise, in particular with certain types of cancers, such as melanoma, which is a big one that's starting to stand out,” Dickens said.

Other cancers with higher rates among Iowa’s teenage and young adult populations are thyroid and colon cancer.

“What keeps us up at night is this slow creep where we are seeing a rising incidence over time,” he said, debunking the theory that advancements in screening technology is the reason.

“Over the last decade or so, we haven't had huge gains in diagnostic tools and that rate continues to rise,” he said.

Compared with the about 2 million U.S. adults diagnosed with cancer annually, pediatric cancer is relatively rare — at 15,000 cases a year, according to Nick Fustino, a pediatric hematologist and oncologist at Blank Children’s Cancer and Blood Disorders in Des Moines.

Iowa sees about 140 new pediatric cancer patients a year treated at either Blank or the UI Stead Family Children’s Hospital, according to Fustino, who said leukemia is the most common among kids.

“This data is really hard to tease out in pediatrics — being such a rare phenomenon,” he said, but added, “what we have seen through large national databases is that there has been a very slow increase in instance of pediatric cancer over the last 50 years.”

That information leads to the obvious question of why, he said.

“What’s causing this?” Fustino asked. “Is there increased gene frequency and predisposition? Are there environmental factors, lifestyle factors?”

Given county-by-county data can be helpful in answering those questions, Dickens raised another challenge with pediatric cancer-rate research.

“We are going to have a problem with breaking this out by county,” he said, citing privacy laws that restrict reporting when numbers are so small. “This is such a rare problem that if a county has a single child that's diagnosed with cancer, we're not allowed to report it because that would break anonymity.”

Big-picture data will be reported, though, Dickens said.

“So please look forward to that in 2026.”

Vanessa Miller covers higher education for The Gazette.

Comments: (319) 339-3158; vanessa.miller@thegazette.com