Iowa has the second highest rate of new cancer cases of any state in the U.S., behind just Kentucky.
The Cancer in Iowa: 99 Counties Project is a public health initiative aimed at enhancing cancer education and community engagement across all of Iowa’s 99 counties. Representatives from the project on Wednesday afternoon (Nov. 5) shared the latest cancer data related to Scott County and provided residents with recommendations on how to reduce cancer risks, detect cases early, and with an opportunity to voice concerns or suggestions.
“We have seen this continued high rate across the state, not only the second highest rate in the country, but one of only two states that is increasing,” said Whitney Zahnd, Assistant Professor, University of Iowa Department of Health Management and Policy and past president of the Iowa Rural Health Association, whose research focuses on cancer prevention.
“That is not the position we’d like to be in, so we like to see this as an opportunity to reverse the trend. The other state that’s increasing is Utah, which has a lot lower rates of cancer than we do,” she said in the Zoom call with local and state health officials, elected leaders, and media.
“There are things we can do as individuals and the role of policies at all levels to reduce risks of cancer, so those are important things as well,” Zahnd said. “As we see this high cancer rate, we’re not seeing a single cancer that’s jumping out – we see it look a little different across the state.”
For example, in northwest Iowa, there’s a higher rate of prostate cancer, whereas urban areas have higher breast cancer rates.
In looking at the cancer rates for Scott County, the top 5 cancers are:
- Female breast cancer. Age-adjusted breast cancer incidence rate for Scott County (150.6 per 100,000) is statistically higher than the state (137.3) and national (131.4) rates. The county ranks 19th statewide.
- Prostate cancer. Age-adjusted prostate cancer incidence rate for Scott County (126.4 per 100,000) is statistically similar to the state rate (129.5), but statistically higher than the national rate (116.5).
- Lung cancer. Age-adjusted lung cancer incidence rate for Scott County (66.3 per 100,000) is statistically higher than the state (60) and national (52.4) rates.
- Uterine (Endometrial). Age-adjusted uterine cancer incidence rate for Scott County (39.1 per 100,000) is statistically higher than the state (31) and national (27.9) rates.
- Colorectal cancer. Age-adjusted colorectal cancer incidence rate for Scott County (36.6 per 100,000) is statistically similar to the state and national rates.
Iowa continues to have one of the highest rates of new cancer diagnoses in the country, according to the annual Cancer in Iowa report by the Iowa Cancer Registry. Iowa remains second in the nation, behind Kentucky, for the rate of new cancers (per 100,000 population), according to the report's age-adjusted data.
The report, which tracks cancer trends, estimated 21,200 Iowans will be diagnosed with cancer this year, while around 6,300 people will die from the disease. Breast, prostate and lung cancers are predicted to be the most common types of cancer diagnoses, making up around 40% percent of new cases.
Zahnd noted that some people even if they’re healthy, can still get cancer.
“That emphasizes the importance of one – the complexity of cancer,” she said. “We can take individual steps to reduce our risks, or things that are going to be outside our control, that is the reality. And also the importance of policies of things that can reduce the risk of things outside of our control.”
“There is not a single cause of cancer, it’s a combination of things. It is a very complicated thing,” Zahnd said. “There are a lot of efforts we can help to hopefully reduce this high rate we have in the state.”
For 2025, in the Iowa Quad Cities, this table shows estimated new cancer cases and deaths by county:
Zahnd said the 99 Counties Project has done presentations on 37 counties so far, and that Scott County is above the national average in cancer incidence.
“The goal of this project is really to engage communities throughout the state, and share information on cancer prevention and control, across all our 99 counties,” Zahnd said Wednesday. They are doing presentations for each Iowa county, sharing county-specific data, and addressing questions and concerns from those who are part of the conversations.
The Iowa Cancer Registry goals include assembling data on new cases and deaths, and supporting studies on cancer research, prevention and education. The registry is supported by National Cancer Institute.
The many risk factors that can increase chances of developing cancer include lifestyle – tobacco, alcohol, diet, physical activity, and UV radiation exposure. Another component is genetics (family history of cancer), as well as exposure to chemicals in the air and water. Age plays a key role, in addition to exposure to viruses, and medical conditions.
Questions regarding the environment, and link between exposures and cancers, are an important area for continued research, Zahnd said.
“There can be many years between exposure to risk factors and cancer development,” she noted. For example, lung cancer may not start until 20 years or after someone starts smoking. Many people who smoke never develop lung cancer, and some people who never smoked have developed lung cancer.
Top Scott County cancer incidence
Amanda Kahl, MPH, Epidemiologist & Data Analyst, Iowa Cancer Registry, walked through the specific data on Scott County incidence for common cancers.
Black, white and Hispanic populations all have higher cancer incidence in the county compared to the national average. And young adults (ages 20-39) have a higher cancer incidence rate in Iowa than the national rate.
Each year, there are about 1,105 new cancers diagnosed in Scott County, the 42nd incidence rate of all Iowa counties.
- Breast cancer: The county has about 163 new cases a year, higher incidence than the state and nation. For mammogram screening (recommended for women ages 40 and up every two years), 84 % of Scott County women (age 50+) are up to date with screenings, higher than the state and nation. For all cancer screenings, if new cases are diagnosed at an earlier stage, it’s easier to treat and there are higher survival rates. 29% of breast cancers are diagnosed at a late stage in the county.
- Prostate cancer: The county averages 143 new prostate cancer cases a year, significantly higher than the national average. In the Black population, there’s a much higher rate in the county compared to the national white population. For screenings, a PSA blood test is recommended for men between 55-69; the American Cancer Society recommends the test for men ages 45 at high risk of prostate cancer (including African-American men). 24% of these cases are diagnosed at late stage as a whole in the county.
- Lung cancer: The county averages about 152 new cases a year, and Scott County has a significantly higher incidence rate of lung cancer than nationally. Lung cancer screening is very low, since it’s still a relatively new guideline, with low-dose CT scans if you have smoked in the last 15 years and are at least 50. In Iowa, only 17% of eligible people have been screened for lung cancer, and a majority of lung cancers are diagnosed at a late stage. In Scott County, 26% of cases were diagnosed at an early stage.
- Uterine cancer: Scott County has about 43 new cases a year, which is significantly higher compared to the nation. This does not have a screening test like other cancers, but there are symptoms – including vaginal bleeding or discharge not related to menstruation; difficult or painful urination, pain during sexual intercourse or pain in the pelvic area.
- Colorectal cancer: Each year, there are about 75 new cases a year in Scott County. The screening guidelines are that people ages 45-75 can test for this cancer with an at-home stool-based test or colonoscopy, and 69% of this population in the county is up to date on this screening. In the Black population, 42% of these cancers are diagnosed at an early stage, compared to 36% in the white population.
About 40 percent of all cancers in the U.S. are attributable to modifiable risk factors like smoking, alcohol, diet, and exercise, Kahl said.
“While we can’t eliminate our risk, there are things we can do to reduce our risk of cancer, which include – not smoking or using any form of tobacco; limiting our alcohol consumption; reducing indoor and outdoor air pollution, which includes radon; enjoying a healthy diet; being physically active; decreasing excess body weight; avoiding too much sun; using sun protection; vaccinating against Hepatitis B and HPV, and also getting appropriate cancer screenings for you,” she said.
Kahl highlighted the importance of the HPV vaccine, since the virus can affect men and women. The vaccine provides safe and effective protection against HPV, thus reducing cancer risk, she said.
It’s recommended children receive it between ages 11-12, when our immune response is best, before ever exposed to HPV, and offers protection for the rest of our life.
Of adolescents 13-15 in Scott County, 50% have received the recommended HPV vaccine series, which is lower than state and national rates, Kahl said, noting the goal is 80%.
After the Iowa tobacco tax increase went into effect in 2007, smoking rates went down in 92% of Iowa counties, including Scott, Kahl said. Smoking is the top cause of lung cancer and radon is second leading cause, and if you’re exposed to both, you have 10 to 20 times higher risk of lung cancer compared to nonsmokers exposed to radon, she said. “By removing one of those risk factors, you can reduce risk of lung cancer.
Among other preventable causes of cancer, binge drinking is a factor and 21% of adults in Scott County reported binge drinking, which is higher than the nation, Kahl said. And 25% of people reported no leisure time physical activity, similar to the state and nation; with 39% in Scott County are obese, higher than state and nation.
Additional Support and Resources
To help understand and address cancer in Iowa communities, there are several resources available. A resource guide is available on the website www.iowacancerregistry.org/99.
The Iowa Cancer Plan has identified the following strategies to significantly reduce the burden of cancer in Iowa:
- Policies that increase opportunities for sun protection in outdoor settings, increase awareness about skin cancer prevention and screening, or decrease use of indoor tanning beds could reduce melanoma rates. As of 2024, 44 states have laws that restrict minor’s use of commercial tanning devices, 20 of which completely ban use of tanning beds for minors. Iowa has no laws restricting use of tanning beds by minors.
According to the 2025 Cancer in Iowa report issued by the Iowa Cancer Registry, there are nearly 172,000 cancer survivors currently living in Iowa, about 5.4% of the population. More than 20,000 people are newly diagnosed with cancer each year in the state.
To find out your cancer risk and ways to lower it, from the American Cancer Society, click HERE.
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