New UI research on Iowa’s high cancer rate reveals troubled counties, high lung cancer rates

DES MOINES — Linn County is among roughly a dozen Iowa counties with significantly higher overall cancer rates, and advanced stage lung cancer is particularly problematic statewide, according to preliminary snapshots into research conducted at the University of Iowa to determine drivers of Iowa’s high cancer rates.

Iowa has the second-highest cancer rate in the U.S. and the only rising state rate.

Gov. Kim Reynolds and state lawmakers last year dedicated $1 million to the University of Iowa to research possible drivers of the state’s high cancer rates. Reynolds and three experts from the University of Iowa’s College of Public Health presented early findings from that research in a press conference Thursday at a state office building.

UI researchers also published their preliminary findings in a report.

The first phase of the research focused on demographic and behavioral risk factors, and the next phase will expand to genetic and environmental risk factors, Reynolds said.

Reynolds’ husband Kevin was diagnosed with lung cancer in 2023 and has received treatments. Reynolds in 2025 said Kevin’s cancer was in remission.

“There are no easy answers to our questions today, but as you’ll see, there’s compelling evidence that will continue to inform the research as it moves forward,” Reynolds said. “I’m committed to sharing those results in a timely and transparent manner because I know how much this information matters to every single Iowan that has been impacted by cancer, including my own.”

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Edith Parker, dean of the University of Iowa College of Public Health, was among the UI experts who joined Reynolds for Thursday’s press conference and spoke to the challenges of determining the driving forces of Iowa’s high cancer rates.

“Fully answering the question of why Iowa has a higher rate of new cancers when compared to the national average would require data from 20 to 30 years ago, and we would need data on each individual in the state, including what they ate and drank, where they lived, exposures to pesticides, chemicals, household products, radon, nitrates, coupled with their genetic profile,” Parker said.

“This kind of individualized information is not collected nationally or in Iowa, so we must rely on the data we do have, and we do have data available. We are using existing data to answer the question, ‘Why does Iowa have a higher rate of new cancers than the national average?’”

While cancer rates are high across the state, once UI researchers adjusted the data for risk factors — like binge drinking, obesity and medical checkup frequency — 13 counties still had cancer rates higher than expected based on a data-driven predicted rate.

The counties with higher than expected rates after adjusting for risk factors were Linn, Jackson, Clinton, Tama, Des Moines, Wapello, Appanoose, Marion, Cass, Woodbury, Cherokee, Palo Alto and Floyd.

UI researchers in their preliminary report said these counties provide “the biggest opportunities for further analysis on additional risk factors such as genetic or environmental.”

The cancer rates in many of Iowa’s neighbor states — which UI researchers considered as a cluster given the states’ geographic proximity and demographic similarities — also are higher than the national average, UI’s research showed. But Iowa’s rates were still higher than those peer states: Wisconsin, Minnesota, North Dakota, South Dakota and Nebraska.

Lung cancer is particularly problematic according to some of the preliminary data.

While much of Iowa’s high cancer rates is driven by early stage, localized cancers that have not yet spread, that is not the case for lung cancer, according to UI researchers. But the state’s high rate of lung cancer is primarily driven by late stage, metastatic cancer — which also contributes to Iowa having a higher lung cancer mortality rate than the rest of the country.

“This is one cancer for which we are not like our neighbors. We have a higher rate and have had a higher rate for the entire time period that we looked at, and the difference seems to be widening,” said Dr. Mary Charlton, professor of epidemiology in the UI College of Public Health and Director of the Iowa Cancer Registry.

“And unfortunately, this plays out into lung cancer having a higher mortality rate in Iowa compared to our neighboring states,” Charlton said. “Although (that rate) fortunately is declining, it’s not declining at as rapid a rate as it is in other states.”

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Governor’s proposal includes tobacco tax increase

Reynolds during Thursday’s press conference unveiled her legislative proposal addressing Iowans’ health — including but not limited to cancer. Reynolds’ sweeping health care bill would:

Asked whether she plans to advocate for repealing Iowa casinos’ exemption from the state’s public smoking ban, Reynolds said she would not weigh in on that proposal during the legislative process — there is a bill in the Iowa House — and instead will focus on her proposed legislation.

Reynolds said she has thought about Kevin while learning from the UI research, particularly regarding lung cancer. She said his was a fast-growing lung cancer that they may not have discovered if it weren’t for the pain it was causing him.

“I did, even when they were presenting the statistics, both earlier and here again. The numbers aren’t good for lung cancer. They’re just not. And it’s really hard to detect,” Reynolds said. “It’s hard to hear the statistics. I won’t lie. It’s a gut punch when you get that call.”

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Comments: (515) 355-1300, erin.murphy@thegazette.com

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