States With the Highest Cancer Rates

November 2, 2017 by Thomas Frohlich

Cancer, the second leading cause of death in the United States, was first recorded as early as 4,000 years ago. The disease affects nearly all Americans, touching the lives both of those fighting the disease, and the many more who either support or have lost someone close to them.

Every year, more than 1.5 million Americans are diagnosed with cancer and more than half a million die from the disease. While cancer death rates have declined in recent years, this is not the case for diagnoses. The total number of new cancer cases is expected to rise by 2020 to nearly 2 million a year. At this rate, cancer will soon be the leading cause of death in the United States, according to the Centers for Disease Control and Prevention (CDC).

Despite the many advances in discovering and managing cancer risk factors, much is still unknown. The likelihood of being diagnosed with cancer depends on a range of factors that contribute to large variations between states. 24/7 Wall St. reviewed the latest cancer diagnosis rates in every state.

Click here to see the incidence of cancer in every state.
Click here to see our methodology and detailed findings.

Correction: An earlier version of this piece identified relatively low smoking rates in 25 states as among the highest rates. For example, Utah’s smoking rate of 9.1% was named the highest. In fact it is the lowest. The ranks have been corrected.

50. New Mexico
> Cancer diagnoses per 100K: 369.9
> Breast cancer diagnoses per 100K: 108.2 (2nd lowest)
> Cancer deaths per 100K: 142.1 (5th lowest)
> Lung cancer deaths per 100K: 38.6 (2nd lowest)
> Adults who currently smoke: 17.5% (tied–25th highest)

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49. Nevada
> Cancer diagnoses per 100K: 374.9
> Breast cancer diagnoses per 100K: 106.6 (the lowest)
> Cancer deaths per 100K: 164.7 (25th highest)
> Lung cancer deaths per 100K: 51.7 (tied–10th lowest)
> Adults who currently smoke: 17.5% (25th highest)

48. Arizona
> Cancer diagnoses per 100K: 379.8
> Breast cancer diagnoses per 100K: 115.0 (9th lowest)
> Cancer deaths per 100K: 142.5 (6th lowest)
> Lung cancer deaths per 100K: 47.1 (7th lowest)
> Adults who currently smoke: 14.0% (7th lowest)

47. Colorado
> Cancer diagnoses per 100K: 395.8
> Breast cancer diagnoses per 100K: 124.9 (24th lowest)
> Cancer deaths per 100K: 136.5 (2nd lowest)
> Lung cancer deaths per 100K: 42.2 (4th lowest)
> Adults who currently smoke: 15.6% (15th lowest)

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46. Utah
> Cancer diagnoses per 100K: 396.0
> Breast cancer diagnoses per 100K: 117.1 (11th lowest)
> Cancer deaths per 100K: 127.8 (the lowest)
> Lung cancer deaths per 100K: 25.6 (the lowest)
> Adults who currently smoke: 9.1% (the lowest)

45. California
> Cancer diagnoses per 100K: 399.6
> Breast cancer diagnoses per 100K: 118.7 (14th lowest)
> Cancer deaths per 100K: 144.4 (7th lowest)
> Lung cancer deaths per 100K: 42.0 (3rd lowest)
> Adults who currently smoke: 11.7% (2nd lowest)

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44. Wyoming
> Cancer diagnoses per 100K: 399.6
> Breast cancer diagnoses per 100K: 124.4 (23rd lowest)
> Cancer deaths per 100K: 141.1 (4th lowest)
> Lung cancer deaths per 100K: 45.2 (6th lowest)
> Adults who currently smoke: 19.1% (16th highest)

43. Texas
> Cancer diagnoses per 100K: 402.2
> Breast cancer diagnoses per 100K: 110.7 (3rd lowest)
> Cancer deaths per 100K: 153.3 (13th lowest)
> Lung cancer deaths per 100K: 51.7 (tied–10th lowest)
> Adults who currently smoke: 15.2% (13th lowest)

42. Hawaii
> Cancer diagnoses per 100K: 406.0
> Breast cancer diagnoses per 100K: 138.0 (4th highest)
> Cancer deaths per 100K: 139.4 (3rd lowest)
> Lung cancer deaths per 100K: 43.7 (5th lowest)
> Adults who currently smoke: 14.1% (8th lowest)

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41. Alaska
> Cancer diagnoses per 100K: 406.6
> Breast cancer diagnoses per 100K: 127.1 (21st highest)
> Cancer deaths per 100K: 165.7 (24th highest)
> Lung cancer deaths per 100K: 54.5 (14th lowest)
> Adults who currently smoke: 19.1% (16th highest)

40. Oregon
> Cancer diagnoses per 100K: 409.6
> Breast cancer diagnoses per 100K: 118.3 (13th lowest)
> Cancer deaths per 100K: 160.5 (21st lowest)
> Lung cancer deaths per 100K: 53.0 (13th lowest)
> Adults who currently smoke: 17.1% (22nd lowest)

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39. Florida
> Cancer diagnoses per 100K: 410.0
> Breast cancer diagnoses per 100K: 114.8 (8th lowest)
> Cancer deaths per 100K: 152.2 (11th lowest)
> Lung cancer deaths per 100K: 57.0 (20th lowest)
> Adults who currently smoke: 15.8% (16th lowest)

38. Virginia
> Cancer diagnoses per 100K: 416.5
> Breast cancer diagnoses per 100K: 131.1 (13th highest)
> Cancer deaths per 100K: 161.8 (tied–23rd lowest)
> Lung cancer deaths per 100K: 57.5 (tied–22nd lowest)
> Adults who currently smoke: 16.5% (20th lowest)

37. Idaho
> Cancer diagnoses per 100K: 420.4
> Breast cancer diagnoses per 100K: 123.2 (20th lowest)
> Cancer deaths per 100K: 155.4 (14th lowest)
> Lung cancer deaths per 100K: 48.8 (8th lowest)
> Adults who currently smoke: 13.8% (5th lowest)

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36. Montana
> Cancer diagnoses per 100K: 431.2
> Breast cancer diagnoses per 100K: 128.0 (18th highest)
> Cancer deaths per 100K: 156.2 (18th lowest)
> Lung cancer deaths per 100K: 52.8 (12th lowest)
> Adults who currently smoke: 18.9% (19th highest)

35. North Dakota
> Cancer diagnoses per 100K: 431.4
> Breast cancer diagnoses per 100K: 114.0 (7th lowest)
> Cancer deaths per 100K: 151.8 (9th lowest)
> Lung cancer deaths per 100K: 58.4 (24th lowest)
> Adults who currently smoke: 18.7% (20th highest)

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34. South Carolina
> Cancer diagnoses per 100K: 433.3
> Breast cancer diagnoses per 100K: 125.1 (25th lowest)
> Cancer deaths per 100K: 171.7 (13th highest)
> Lung cancer deaths per 100K: 64.2 (17th highest)
> Adults who currently smoke: 19.7% (14th highest)

33. Indiana
> Cancer diagnoses per 100K: 435.8
> Breast cancer diagnoses per 100K: 121.6 (17th lowest)
> Cancer deaths per 100K: 180.0 (7th highest)
> Lung cancer deaths per 100K: 68.6 (11th highest)
> Adults who currently smoke: 20.6% (12th highest)

32. Michigan
> Cancer diagnoses per 100K: 437.3
> Breast cancer diagnoses per 100K: 117.0 (10th lowest)
> Cancer deaths per 100K: 173.8 (12th highest)
> Lung cancer deaths per 100K: 63.4 (18th highest)
> Adults who currently smoke: 20.7% (11th highest)

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31. Alabama
> Cancer diagnoses per 100K: 437.9
> Breast cancer diagnoses per 100K: 120.5 (16th lowest)
> Cancer deaths per 100K: 177.7 (10th highest)
> Lung cancer deaths per 100K: 65.0 (16th highest)
> Adults who currently smoke: 21.4% (10th highest)

30. Maryland
> Cancer diagnoses per 100K: 439.5
> Breast cancer diagnoses per 100K: 129.8 (16th highest)
> Cancer deaths per 100K: 162.0 (24th lowest)
> Lung cancer deaths per 100K: 55.4 (tied–17th lowest)
> Adults who currently smoke: 15.1% (11th lowest)

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29. Oklahoma
> Cancer diagnoses per 100K: 442.0
> Breast cancer diagnoses per 100K: 120.4 (15th lowest)
> Cancer deaths per 100K: 179.7 (8th highest)
> Lung cancer deaths per 100K: 69.5 (9th highest)
> Adults who currently smoke: 22.2% (6th highest)

28. Washington
> Cancer diagnoses per 100K: 442.1
> Breast cancer diagnoses per 100K: 134.8 (7th highest)
> Cancer deaths per 100K: 155.7 (16th lowest)
> Lung cancer deaths per 100K: 55.4 (tied–17th lowest)
> Adults who currently smoke: 15.0% (9th lowest)

27. Nebraska
> Cancer diagnoses per 100K: 443.6
> Breast cancer diagnoses per 100K: 124.0 (21st lowest)
> Cancer deaths per 100K: 158.9 (19th lowest)
> Lung cancer deaths per 100K: 56.9 (19th lowest)
> Adults who currently smoke: 17.1% (22nd lowest)

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26. Tennessee
> Cancer diagnoses per 100K: 445.7
> Breast cancer diagnoses per 100K: 118.0 (12th lowest)
> Cancer deaths per 100K: 184.3 (5th highest)
> Lung cancer deaths per 100K: 73.8 (5th highest)
> Adults who currently smoke: 21.9% (7th highest)

25. Missouri
> Cancer diagnoses per 100K: 447.0
> Breast cancer diagnoses per 100K: 128.9 (17th highest)
> Cancer deaths per 100K: 177.3 (11th highest)
> Lung cancer deaths per 100K: 71.9 (7th highest)
> Adults who currently smoke: 22.3% (5th highest)

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24. Vermont
> Cancer diagnoses per 100K: 447.2
> Breast cancer diagnoses per 100K: 135.9 (6th highest)
> Cancer deaths per 100K: 167.8 (18th highest)
> Lung cancer deaths per 100K: 61.3 (23rd highest)
> Adults who currently smoke: 16.0% (18th lowest)

23. North Carolina
> Cancer diagnoses per 100K: 448.8
> Breast cancer diagnoses per 100K: 129.9 (15th highest)
> Cancer deaths per 100K: 169.7 (14th highest)
> Lung cancer deaths per 100K: 67.3 (tied–12th highest)
> Adults who currently smoke: 19.0% (18th highest)

22. Kansas
> Cancer diagnoses per 100K: 449.1
> Breast cancer diagnoses per 100K: 125.5 (25th highest)
> Cancer deaths per 100K: 166.6 (20th highest)
> Lung cancer deaths per 100K: 60.1 (25th highest)
> Adults who currently smoke: 17.7% (23rd highest)

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21. South Dakota
> Cancer diagnoses per 100K: 450.1
> Breast cancer diagnoses per 100K: 122.3 (18th lowest)
> Cancer deaths per 100K: 163.3 (25th lowest)
> Lung cancer deaths per 100K: 56.3 (18th lowest)
> Adults who currently smoke: 20.1% (13th highest)

20. Ohio
> Cancer diagnoses per 100K: 452.1
> Breast cancer diagnoses per 100K: 126.6 (23rd highest)
> Cancer deaths per 100K: 177.8 (9th highest)
> Lung cancer deaths per 100K: 67.0 (14th highest)
> Adults who currently smoke: 21.6% (9th highest)

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19. Georgia
> Cancer diagnoses per 100K: 453.4
> Breast cancer diagnoses per 100K: 124.4 (23rd lowest)
> Cancer deaths per 100K: 166.2 (22nd highest)
> Lung cancer deaths per 100K: 63.0 (21st highest)
> Adults who currently smoke: 17.7% (23rd highest)

18. Massachusetts
> Cancer diagnoses per 100K: 453.8
> Breast cancer diagnoses per 100K: 138.4 (3rd highest)
> Cancer deaths per 100K: 155.6 (15th lowest)
> Lung cancer deaths per 100K: 61.5 (22nd highest)
> Adults who currently smoke: 14.0% (7th lowest)

17. Arkansas
> Cancer diagnoses per 100K: 456.2
> Breast cancer diagnoses per 100K: 113.9 (6th lowest)
> Cancer deaths per 100K: 182.9 (6th highest)
> Lung cancer deaths per 100K: 77.4 (3rd highest)
> Adults who currently smoke: 24.9% (3rd highest)

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16. Minnesota
> Cancer diagnoses per 100K: 457.7
> Breast cancer diagnoses per 100K: 130.9 (14th highest)
> Cancer deaths per 100K: 152.5 (12th lowest)
> Lung cancer deaths per 100K: 52.3 (11th lowest)
> Adults who currently smoke: 16.2% (19th lowest)

15. Wisconsin
> Cancer diagnoses per 100K: 459.0
> Breast cancer diagnoses per 100K: 126.9 (22nd highest)
> Cancer deaths per 100K: 161.8 (tied–23rd lowest)
> Lung cancer deaths per 100K: 57.9 (23rd lowest)
> Adults who currently smoke: 17.3% (23rd lowest)

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14. Illinois
> Cancer diagnoses per 100K: 460.4
> Breast cancer diagnoses per 100K: 133.5 (9th highest)
> Cancer deaths per 100K: 169.2 (tied–16th highest)
> Lung cancer deaths per 100K: 65.6 (15th highest)
> Adults who currently smoke: 15.1% (11th lowest)

13. West Virginia
> Cancer diagnoses per 100K: 461.0
> Breast cancer diagnoses per 100K: 111.4 (4th lowest)
> Cancer deaths per 100K: 194.7 (2nd highest)
> Lung cancer deaths per 100K: 77.6 (2nd highest)
> Adults who currently smoke: 25.7% (2nd highest)

12. Mississippi
> Cancer diagnoses per 100K: 462.1
> Breast cancer diagnoses per 100K: 113.8 (5th lowest)
> Cancer deaths per 100K: 193.0 (3rd highest)
> Lung cancer deaths per 100K: 73.9 (4th highest)
> Adults who currently smoke: 22.5% (4th highest)

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11. New Hampshire
> Cancer diagnoses per 100K: 464.2
> Breast cancer diagnoses per 100K: 144.9 (the highest)
> Cancer deaths per 100K: 159.8 (20th lowest)
> Lung cancer deaths per 100K: 60.9 (24th highest)
> Adults who currently smoke: 15.9% (17th lowest)

10. Connecticut
> Cancer diagnoses per 100K: 467.0
> Breast cancer diagnoses per 100K: 142.0 (2nd highest)
> Cancer deaths per 100K: 146.8 (8th lowest)
> Lung cancer deaths per 100K: 59.2 (25th lowest)
> Adults who currently smoke: 13.5% (4th lowest)

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9. Rhode Island
> Cancer diagnoses per 100K: 469.8
> Breast cancer diagnoses per 100K: 133.2 (10th highest)
> Cancer deaths per 100K: 166.4 (21st highest)
> Lung cancer deaths per 100K: 69.6 (8th highest)
> Adults who currently smoke: 15.5% (14th lowest)

8. Iowa
> Cancer diagnoses per 100K: 471.9
> Breast cancer diagnoses per 100K: 125.9 (24th highest)
> Cancer deaths per 100K: 165.8 (23rd highest)
> Lung cancer deaths per 100K: 63.3 (19th highest)
> Adults who currently smoke: 18.1% (21st highest)

7. New Jersey
> Cancer diagnoses per 100K: 472.8
> Breast cancer diagnoses per 100K: 134.3 (8th highest)
> Cancer deaths per 100K: 156.1 (17th lowest)
> Lung cancer deaths per 100K: 55.4 (tied–17th lowest)
> Adults who currently smoke: 13.5% (4th lowest)

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6. Maine
> Cancer diagnoses per 100K: 474.6
> Breast cancer diagnoses per 100K: 127.9 (19th highest)
> Cancer deaths per 100K: 169.6 (15th highest)
> Lung cancer deaths per 100K: 72.1 (6th highest)
> Adults who currently smoke: 19.5% (15th highest)

5. New York
> Cancer diagnoses per 100K: 476.5
> Breast cancer diagnoses per 100K: 132.3 (11th highest)
> Cancer deaths per 100K: 152.1 (10th lowest)
> Lung cancer deaths per 100K: 57.5 (tied–22nd lowest)
> Adults who currently smoke: 15.2% (13th lowest)

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4. Pennsylvania
> Cancer diagnoses per 100K: 477.3
> Breast cancer diagnoses per 100K: 132.0 (12th highest)
> Cancer deaths per 100K: 169.2 (tied–16th highest)
> Lung cancer deaths per 100K: 63.2 (20th highest)
> Adults who currently smoke: 18.1% (21st highest)

3. Louisiana
> Cancer diagnoses per 100K: 478.7
> Breast cancer diagnoses per 100K: 122.7 (19th lowest)
> Cancer deaths per 100K: 186.1 (4th highest)
> Lung cancer deaths per 100K: 68.8 (10th highest)
> Adults who currently smoke: 21.9% (7th highest)

2. Delaware
> Cancer diagnoses per 100K: 488.1
> Breast cancer diagnoses per 100K: 136.9 (5th highest)
> Cancer deaths per 100K: 166.9 (19th highest)
> Lung cancer deaths per 100K: 67.3 (tied–12th highest)
> Adults who currently smoke: 17.4% (24th lowest)

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1. Kentucky
> Cancer diagnoses per 100K: 513.7
> Breast cancer diagnoses per 100K: 127.3 (20th highest)
> Cancer deaths per 100K: 199.1 (the highest)
> Lung cancer deaths per 100K: 91.4 (the highest)
> Adults who currently smoke: 25.9% (the highest)

Detailed Findings and Methodology

Breast cancer is the most commonly diagnosed form of cancer in every state except for Louisiana and Mississippi, where prostate cancer is more frequently diagnosed. But breast and prostate cancer, while experienced by relatively more people, are not the deadliest forms of the disease.

Of all known cancer types, lung-related cancers are the top killers in nearly every state. Of the 25 states with higher cancer mortality rates, all but two have adult smoking rates that exceed the national rate of approximately 17%. In the three states with the highest mortality rates from any cancer — Kentucky, West Virginia, and Mississippi — more than 1 in every 5 adults smokes.

Utah, the state with the nation’s lowest smoking rate and the lowest lung cancer death rate, is the only exception. Adjusted for age, breast cancer is the top killer in the state. In absolute terms, however, lung cancer still kills the most people of all the cancers in Utah.

There is no clear pattern between income levels in a state and cancer diagnosis rates. For example, Texas, Arizona, and New Mexico — three states with relatively low cancer incidence rates — are also some of the nation’s poorest states. Meanwhile, relatively high income states like Pennsylvania, New York, and New Jersey report among the top 10 cancer incidence rates.

Mortality rates, on the other hand, do appear related to financial status. The median annual household income does not exceed the national level of $55,775 in any of the 10 states with the highest cancer mortality rates. With few exceptions, the opposite is the case in states with lower cancer mortality rate.

To identify the incidence of cancer in every state, 24/7 Wall St. reviewed the age-adjusted cancer incidence rate in every state from data compiled by the Centers for Disease Control and Prevention. The rate represents the number of new events during a given time frame (2014) in a given geographic area (state) per 100,000 people. The data is from the report, “United States Cancer Statistics: 1999-2014 Incidence and Mortality Web-based Report,” produced by the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute, published 2017. The percentage of adults who currently smoke in each state was also obtained from the CDC.

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