Ohio small-business owner Joe Wurzelbacher stepped into the national spotlight during the 2008 presidential election cycle when he became known as “Joe The Plumber,” appearing on national TV as a conservative activist and symbol of the struggling middle-class entrepreneurs Republicans said would be crippled by Barack Obama’s proposed tax policies.

On Aug. 27 of this year, the husband, veteran, and father of four died at 49 from pancreatic cancer, his death first announced as an update to an online fundraiser curated by friends of the family. Out of more than 200 known types of the disease that causes cells to grow uncontrollably, pancreatic cancer is one of the most dangerous because it’s difficult to identify in its early stages, when treatment would be most effective. (These will be the deadliest cancers in 2023.)

According to a data analysis from the National Program for Cancer Registries database, the rate of early-onset pancreatic cancer – that which affects those younger than 55 – is increasing. There’s better news about cancer in general, however: Fewer Americans are dying from it, thanks to factors including advances in treatment, an increase in early detection, and a drop in tobacco use.  

About 1.95 million Americans across the 50 states are expected to be diagnosed with cancer by the end of this year, and their chances of survival are much higher than they used to be. In the mid-’70s the average cancer survival rate beyond five years from diagnosis was 49% – essentially a coin flip. As of 2018, that rate had risen to 68%. In 1990, 216 out of 100,000 Americans died from cancer. By 2020, the rate was 144.1 – a 33% decline. 

The most common forms of the disease are prostate and female breast cancer, which make up between 14% and 22% of all cancer cases nationwide. Prostate cancer, along with thyroid and testis cancers and melanoma, have the highest five-year survival rates – between 94% and 98%. (The cancer that killed Wurzelbacher? The rate is just 12%.) 

To identify the states that will have the highest rate of new cancer diagnoses by the end of 2023, 24/7 Tempo reviewed the estimated number of new cancer cases this year from the American Cancer Society’s Cancer Statistics Center. Each state’s population and percentage of adults who had health insurance in 2021 came from the U.S. Census Bureau’s American Community Survey and are 5-year averages. (Here are the 21 states where the most people don’t have health insurance.)

Click here to see the states estimated to have the highest rate of new cancer cases by the year