Top 5 Cancerous States in the U.S.: Is Your State One of Them?


Cancer: The word itself makes many Americans shutter in fear. The United States has the 7th highest cancer rate in the world. Yet, within its borders, incident rates vary greatly depending on geographic location — they can be as low as 380.4 incidents per 100,000 people, to as high as 510.7 incidents per 100,000 people. This, according to the Center for Disease Control and Prevention (CDC), who issued their full statistical report two Thursdays ago, on the 15th of October.

Statistics show a significant trend east of the Mississippi River where cancer incidences are at the highest levels in the country. Kentucky, Mississippi, West Virginia, Louisiana, and Oklahoma all have, in order, the highest incidence rates. Utah, Hawaii, Colorado, New Mexico, and Alaska have the lowest rates of cancer in the country.

But why the disparity? What variables contribute to cancer incident rates in the U.S.?

Patterns of Cancer Incidences across the U.S.

There is a long list of factors that play a role in cancer incidence and mortality rates. Some factors, as you might’ve guessed, are behavioral, such things as diet, smoking, and alcohol use – and even the amount of time one might choose to spend in the sun. Some factors are demographic – ethnicity, socioeconomic status, and age can all contribute to higher or lower cancer rates. A third category is that of occupational and environmental exposures to contaminants, carcinogens, chemicals, and/or radiation – the frequency of which can all also affect cancer incidence rates.

While ongoing analysis is underway to better understand the pattern of cancer incidence across the country, a recent U.S. News report sheds more light on which states have the highest rates of cancer and why.

U.S. States with Highest Cancer Rates

U.S. States with Highest Cancer Rates

#5 Oklahoma

For every 100,000 Oklahoma residents, an average of 490 people are diagnosed with cancer each year – the majority of which are lung cancers. The annual mortality rate in the state is also considerably high – higher than the national average of 179 cancer deaths per 100,000 people. Statistics hint at the idea that this might largely be related to behavior. Compared to the country’s 3 healthiest states – Hawaii, Vermont, and Massachusetts – Oklahoma residents have relatively unhealthy behaviors, including a higher prevalence of smoking. People also have less access to “healthier” food, and are prone to develop unhealthy eating habits.

#4 Louisiana

Louisiana has a high rate of adults with a history of smoking and holds the country’s second-worst obesity rate. Poverty in the Bayou State is very high as well, with more residents unable to afford the cost associated with seeing a doctor. As with Oklahoma, many Louisiana residents also do not have access to nutritious food choices. For every 100 people diagnosed with cancer, roughly 40 people die – making Louisiana a state with the 4th worst mortality-to-incidence rates.

#3 West Virginia

Like most of the states with high cancer mortality rates, health-related risk factors play a role in West Virginia. A high proportion of West Virginia adults report a history of tobacco consumption. As with Louisiana, the obesity rate in West Virginia is also very high. Poverty is also a factor, with a high proportion of adults reporting they can’t afford to visit a doctor. Additionally, West Virginians have a significant occupational-exposure risk with high employment in coal mining, manufacturing, and factory jobs. Statistics show that lung cancer is the largest contributor to the cancer mortality rate in West Virginia compared to other forms of cancer.

#2 Mississippi

Just like its Gulf Coast neighbor, Louisiana, Mississippi, too, has significant obesity and poverty rates. Roughly 35-percent of residents are listed as obese; 24-percent live in poverty. Statistics show financial burdens make accessing healthcare extremely difficult, with nearly 1 in 5 Mississippi residents saying they cannot see a doctor due to cost constraints. One other factor to consider is that there are also very few primary physicians in Mississippi – only 26.5 doctors per 100,000 people, which is the lowest ratio nationwide. The oral cancer mortality rate in the state is more than three times higher than the national rate. The mortality rate for bone cancer and some forms of leukemia are more than 2 times the national average as well.

#1 Kentucky

Unfortunately, it’s Kentucky that has the highest cancer mortality rate, the highest incidence rate, and, perhaps relatedly, one of the highest smoking rates in the country. More than 25-percent of Kentucky adults report a history of tobacco use. Poor economic factors, including a poverty rate of 19-percent, make staying healthy a challenge for many residents in the Bluegrass State. Potentially dangerous work environments are another cancer-risk factor in Kentucky. Men and women in the state were more likely than most Americans to work in the mining industry and at jobs that involve exposure to higher levels of carcinogens and inhalants. The lung cancer mortality rate of 76.1 deaths per 100,000 people is the highest in the country, compared to the national average of 51.9. Kentucky also reports the highest incidence of breast cancer in the country.

Prime Cancer-Causing Factors in the U.S.

There are 4 distinct cancer types that are diagnosed more in the U.S. than any other forms of cancer.

  • Prostate cancer
  • Breast cancer
  • Lung and bronchus cancer
  • Colorectal cancer

While there are a number of variables at work, research shows obesity is one of the major cancer-causing risk factors. In addition, obesity can lead to a number of other serious diseases such as type 2 diabetes and heart disease.

Many are likely already aware, but another prime cancer-causing factor in the U.S. is smoking. According to a compilation from, Kentucky and Louisiana rank third and fourth in terms of the percentage of adult smokers. By comparison, the states with the lowest incidences of cancer report a small percentage of adults who have a history of tobacco use. In fact, Utah — the state with the least incidents of cancer — reports an adult smoking rate of less than 10-percent.

The Good News: U.S. Cancer Mortality Trend Declines

According to the National Cancer Institute (NCI), the overall cancer death rate has declined since 1990s. The most recent Annual Report to the Nation on the Status of Cancer, published in March 2015, shows that from 2002 to 2011, cancer death rates decreased by:

  • 8-percent per year among men
  • 4-percent per year among women
  • 1-percent per year among children ages 0-14
  • 3-percent per year among children ages 0-19

This trend shows that progress is being made to decrease the incidents of cancer. Dr. Ahmedin Jemal, the American Cancer Society's vice president of surveillance and health services research, says, “Convincing Americans to quit smoking has been the major driver in reducing cancer deaths. The number of smokers has been cut in half, and now represents fewer than 1 of every 5 people in the United States.”

In fact, according to the CDC, low tobacco use — along with lower obesity rates and better financial stability make these 5 states the healthiest in the country.

  1. Hawaii
  2. Vermont
  3. Massachusetts
  4. Connecticut
  5. Utah
Sokolove Law Team

Contributing Authors

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Last modified: September 29, 2020