Cancer was the second-leading cause of death, after heart disease, in the United States in 2020, according to the Centers for Disease Control and Prevention. There were 602,350 cancer fatalities in the U.S. in 2020. 

Lung cancer was the leading cause of cancer death, accounting for 23% of all cancer deaths, followed by cancers of the colon and rectum (9%), pancreas (8%), female breast (7%) and liver and intrahepatic bile duct (5%), according to the CDC. More males died from lung, colorectal, and pancreatic cancer than females.

Unfortunately, cancer death rates are higher in some parts of the country than others. (Cancer incidence also varies by state. This is the state where the most people are getting cancer.)

To find the states where the most people die of cancer, 24/7 Tempo reviewed cancer mortality statistics by state for 2020 from the Centers for Disease Control and Prevention. States were ranked by the age-adjusted cancer death rate – i.e. cancer deaths per 100,000 population. 

We also included adult smoking, obesity, and inactivity rates for 2020 from County Health Rankings & Roadmaps, a program of the University of Wisconsin Population Health Institute and Robert Wood Johnson Foundation. Median household income figures are five-year estimates for 2020 from the Census Bureau American Community Survey.

States with higher levels of smoking, obesity, and inactivity rates, as well as low median household incomes, tend to have higher cancer death rates. Many of the states that have higher obesity and inactivity rates and lower median household income are in the South and the Rust Belt. Some of the states with elevated smoking levels  are states that grow the most tobacco such as Kentucky and Tennessee. (More locally, this is the county with the highest smoking rate in every state.)

States with fewer cancer death rates are mostly in the West: California, Arizona, Utah, Colorado, and New Mexico. Nine of the 10 states with the lowest cancer death rates also have among the 10 lowest smoking rates. 

There is good news in the fight against cancer. From 2001 to 2020, cancer death rates declined 27%, from 196.5 deaths per 100,000 population to 144.1 deaths per 100,000. The CDC attributes the drop to public campaigns about the health risks of using tobacco, cancer vaccines, diagnostic practices, and screening tests.

Click here to see the states where the most people die of cancer