Which States Have the Highest and Lowest Cancer Rates?

We reviewed the most recently released CDC data from 2023 for incidence rates and 2024 for mortality rates to rank the states facing the highest and lowest cancer rates. We calculated the total new cancer incidences per 100,000 residents to determine these rates.

Kentucky has the highest cancer rate in the country at 530.5 cases per 100,000 residents, while Arizona has the lowest at 375.4 per 100,000. Smoking prevalence, obesity, healthcare access and screening rates all contribute to the gap between states.

States With the Highest Cancer Rates

Three states have the highest cancer rates in the country, based on the CDC’s data. Kentucky leads at 530.5 per 100,000 residents, followed by West Virginia at 517.8 and Louisiana at 514.2. All of these states are more than 75 points above the national incidence rate of 455 per 100,000.

Iowa (511.9) and Minnesota (507.5) round out the top 5. The states with the highest rates span across two regions. Appalachian states have historically had less access to preventive health resources, which is reflected in higher rates of smoking and obesity, while Midwestern states have older populations and strong screening programs that catch more cases at earlier stages.

Cancer Rates Highest in Kentucky

Kentucky doesn’t just lead the country in overall new cancer cases. The state also has the highest rate of new lung cancer cases, the second-highest rates of both colon and pancreatic cancers and the third-highest rate of laryngeal cancer. It’s worth noting that Kentucky has the nation’s fifth-lowest rate of ovarian cancer.

Poor healthcare access, high poverty rates, smoking and obesity all contribute to Kentucky’s position with 16% of the state’s population living in poverty. Adults with obesity make up 36% of the population. About 18% of Kentucky adults smoke, tying the state for the fourth-highest adult smoking rate in the country, behind West Virginia (22%), Arkansas (20%) and Tennessee (19%).

Cancer Death Rates by State

Cancer death rates tell a similar but not identical story to incidence rates. Kentucky has the highest cancer death rate in the country at 175.2 deaths per 100,000 residents, based on 2024 CDC data. West Virginia (174.0) and Oklahoma (171.7) follow closely. Hawaii has the lowest cancer death rate at 115.2 per 100,000, then Utah (117.7) and New York (118.3).

States With the Highest 2024 Cancer Death Rates

• Kentucky: 175.2 per 100,000
• West Virginia: 174.0 per 100,000
• Oklahoma: 171.7 per 100,000

The 3 states with the highest cancer death rates all share common risk factors, including high smoking rates, limited healthcare access and elevated poverty levels. These conditions make it harder for people to get screened early, when treatment is most effective.

Death rates have dropped meaningfully over the past 25 years. National cancer mortality has fallen nearly 30% since 1999. 35 states plus Washington, D.C. have seen declines of at least 25%. Earlier detection through mammography, colonoscopy and lung CT screening, along with better lung cancer treatment, has driven much of that progress.

States With the Lowest Cancer Rates

Arizona, New Mexico and Colorado have the lowest cancer rates in the country. Arizona leads at 375.4 cases per 100,000 residents, about 80 points below the national average. New Mexico (378.8) and Colorado (385.6) follow closely behind.

Beyond the states in the top 3, those with the lowest rates are located on opposite sides of the country. They’re in the Mountain West, including Nevada, Wyoming and Oregon, and high-screening states with dense healthcare infrastructure. The states with the lowest cancer rates don’t all share an obvious common thread. Researchers haven’t identified a single scientific explanation for why certain regions consistently record lower rates than others.

Cancer Rates Lowest in Arizona

Arizona has the lowest overall cancer rate in the country, a distinction it has held consistently in recent years. The state also has the lowest prostate cancer rate in the country at 77.3 per 100,000 males, less than half the national rate. Arizona’s lung and bronchus cancer rate of 33.6 per 100,000 is well below the national average of 50.1, ranking among the lowest in the country. For female breast cancer, Arizona’s rate of 114.6 per 100,000 is the second lowest nationally, trailing only Nevada (114.2).

Researchers haven’t identified a single scientific explanation for why Arizona consistently records lower cancer rates than most other states. Lower smoking rates, a younger and more transient population and differences in screening patterns may all contribute.

How States Rank With the Most Common Cancers

The most common cancers impacting Americans are breast cancer, prostate cancer and lung cancer, according to the National Cancer Institute. Each year, these three cancer types account for a significant share of all new cancer diagnoses in the United States, and the states with the highest rates for each don’t always overlap with those that top the overall incidence rankings.

Breast Cancer Rates in the U.S.

Delaware has the highest breast cancer rate in the country at 153.9 per 100,000 residents, with Rhode Island a close second at 152.9. Several Northeastern states dominate the top of this list, which may reflect higher screening rates in the region rather than a true increase in cancer risk.

Nevada has the lowest breast cancer rate in the country at 114.2 per 100,000 residents. However, new cases still number in the thousands each year.

Men are at the greatest risk of prostate cancer in Louisiana, based on current statistics. Because the risk of African American males dying from low-grade prostate cancer is double that of men of other races, Louisiana’s large African American population is significant in understanding the heightened proportion of prostate cancer cases.

The full list of five states with the highest prostate cancer rates is Louisiana (148.9), Nebraska (141.6), New Jersey (139.1), Mississippi (138.3) and Montana (134.8). On the other end of the spectrum, Arizona experiences less than half the prostate cancer rate of Louisiana (71.1 vs. 148.9).

Prostate Cancer Rates in the U.S.

Louisiana has the highest prostate cancer rate in the country at 160.7 per 100,000 residents. Because the risk of African American men dying from low-grade prostate cancer is double that of men of other races, Louisiana’s large African American population is significant in understanding the heightened proportion of prostate cancer cases.

Arizona has the lowest prostate cancer rate in the country at 81.5 per 100,000. This is less than half of Louisiana’s rate.

Lung Cancer Rates in the U.S.

Regardless of where you live, lung cancer is the No. 1 cancer killer for men and women in the United States. Kentucky has the highest lung cancer rate in the country at 82.7 per 100,000 residents, more than 32 points above the national average of 50.1 per 100,000. Recent research notes that lung cancer heavily impacts people living in economically challenged Appalachian communities of Kentucky.

All of the states that top this list also have a large percentage of adult smokers. West Virginia leads adult smoking prevalence at 22%, then Arkansas (20%) and Tennessee, Kentucky, Missouri, Ohio and Mississippi at 18% each. Puerto Rico has the lowest lung cancer rate at 13.3 per 100,000.

As Dr. Jacques Fontaine, thoracic surgeon and director of the Mesothelioma Research and Treatment Center at Moffitt Cancer Center, tells us, “Only 13% of patients who are eligible for lung cancer screening actually get screened. That’s a shame. This is a missed opportunity. It is a fact that the earlier we catch a cancer, whether breast cancer, colon cancer, cervical cancer or lung cancer, the better the outcome, the higher the chance of a cure.”

Exclusive Content

Dr. Jacques Fontaine: Lung Cancer Screenings Save Lives

View Transcript

It is a fact that the earlier we catch a cancer, whether breast cancer, colon cancer, cervical cancer, or lung cancer, the better the outcome, the higher the chance of a cure. So it’s so important to not wait for somebody to get symptoms before we catch this cancer. How do we do that? Through screening. Most of you are familiar that there are screening mammograms for breast cancer, colonoscopies for colon cancer, a PSA blood test for men for prostate cancer. There has been lung cancer screening approved and paid for by insurance companies as well as Medicare in the United States for the last twelve years.


And we know that lung cancer screening with a CAT scan once a year saves lives.


The vast majority of patients who are found to have lung cancer through a screening CAT scan have stage one lung cancer where the chance of a cure is excellent.


Despite that, despite being around for the last ten years and paid for by Medicare, only thirteen percent of patients who are eligible for lung cancer screening actually get screened. That’s a shame. This is a missed opportunity. We can do better.


We can catch patients with lung cancer earlier, have a better chance of a cure. So patients who are men and women over the age of fifty, or either current smokers or past smokers, I urge you, please go get the annual CT scan to screen for lung cancer. So God forbid, should you have one, we have a very good chance of a cure by removing it with surgery. Lung cancer screening saves lives.

Reasons for the Differences in State Cancer Rates

There is no one reason to explain why your home state’s cancer rates may differ from another. A multitude of factors contribute to these discrepancies from state to state.

Factors That Affect State Cancer Rates

• Access to resources: Poverty can directly impact a person’s access to medical care, including critical cancer screenings. Early detection through screenings creates greater chances for survival. Low awareness of potential symptoms and cancer risks can lead to delayed diagnoses and increased fatalities.
• Obesity rates: According to the CDC, 13 types of cancer are associated with obesity, including breast, esophageal, thyroid and pancreatic. Together, these account for 40% of all cancer diagnoses in the United States each year.
• Rising-rate states: While the national cancer incidence rate has dropped 5.5% since 1999, 12 states have seen rates rise over the same period. Tennessee saw the largest increase at 19.1%, then Minnesota (8.8%) and North Carolina (7.4%). Researchers attribute these increases to aging populations, environmental exposures and rising obesity rates.
• Screening and early detection: States with higher mammography, colonoscopy and lung CT screening rates often record higher incidence rates because more cases are caught earlier. This is likely why Iowa and Minnesota appear high on incidence rankings but more favorably on mortality rankings.
• Smoking Rates: States with higher numbers of adult smokers often have higher cancer rates. West Virginia leads adult smoking prevalence at 22%, then Arkansas (20%) and Tennessee, Kentucky, Missouri, Ohio and Mississippi at 18% each (CDC, 2023). Smoking is responsible for at least 87% of lung cancer deaths.

In 2023, there were 1,941,540 new cancer cases across the country. Understanding these statistics creates opportunities to better appreciate the profound effect cancer has on the American public.

Methodology

To identify the states with the highest and lowest cancer rates in the country, we reviewed statistical data from the CDC tracking the rate of new cancers in the United States. We calculated the total new cancer incidences per 100,000 state residents to formulate each state’s rate. Results were then ranked for 24 different cancer types and an overall total of cancer cases for each state.

Frequently Asked Questions

What state has the highest cancer rate?

Kentucky has the highest cancer rate in the U.S. at 530.5 new cases per 100,000 residents, based on 2023 CDC data. The state’s rate is more than 16% above the national average of 455 per 100,000.

What state has the lowest cancer rate?

Arizona has the lowest cancer rate in the U.S. at 375.4 new cases per 100,000 residents, based on 2023 CDC data. New Mexico and Colorado round out the 3 lowest at 378.8 and 385.6 per 100,000.

Why does Kentucky have the highest cancer rate?

High lung cancer incidence, tied to historic tobacco use, elevated indoor radon exposure in coal-mining regions and limited healthcare access in rural Appalachia contribute to Kentucky’s cancer rate. The state has an 18% adult smoking rate and 36% adult obesity rate with 16% of residents living in poverty.

Which state has the highest cancer death rate?

Kentucky has the highest cancer death rate in the U.S. at 175.2 deaths per 100,000 residents, based on 2024 CDC data. West Virginia (174.0) and Oklahoma (171.7) follow. Hawaii has the lowest cancer death rate at 115.2 per 100,000.

Are cancer rates rising or falling in the U.S.?

Nationally, cancer incidence rates have fallen 5.5% since 1999, from 481.6 to 455 per 100,000. Cancer death rates have dropped nearly 30% over the same period, largely because of earlier detection and improved lung cancer treatment. However, 12 states, Tennessee (19.1%), Minnesota (8.8%) and North Carolina (7.4%), have seen incidence rates rise.

Which states have seen the largest increase in cancer rates?

While the national cancer incidence rate has fallen 5.5% since 1999, 12 states have seen rates rise over the same period. Tennessee reported the largest increase at 19.1%, then Minnesota (8.8%) and North Carolina (7.4%). Researchers attribute these increases to aging populations, environmental exposures and rising obesity rates.