10 States Where Cancer Incidence Is the Highest

I would attest that there is perhaps no word or diagnosis scarier to me in the English language than cancer. A survey conducted in 2010 by Cancer Research UK in Britain would appear to agree with me, as more respondents chose cancer as their biggest fear over a number of other ailments including Alzheimer's disease, a heart attack, or being in a plane crash.

The reasons cancer is often viewed so negatively is twofold.

Source: Novartis.

First, we still have very little understanding as to how cancer cells form, activate, and replicate in the first place. This isn't to say that there isn't novel research going on at this very moment into specific proteins and characteristics within cancer cells that can help us fight their replication process, but generally speaking, if we understood how cancer worked we'd probably have considerably higher overall response rates for a number of cancer treatments, wouldn't we?

Second, there are also a number of common misconceptions built into a cancer diagnosis -- the worst of all being that getting cancer is a roll of the dice, and that there's nothing you can do to reduce your chance of developing cancer. Although certain cancer risks are based on hereditary (i.e., genetic) factors, about one-third of cancer incidence can be reduced or eliminated by simple lifestyle habit corrections according to the latest report from the World Health Organization. WHO suggests simple factors like quitting tobacco products, not drinking alcohol, eating healthfully, and avoiding becoming overweight or obese are key factors to reducing your risk of developing cancer.

10 states where cancer incidence in the highest
Within the United States, according to the Centers for Disease Control and Prevention, cancer incidence rates (inclusive of all types of cancers) can vary wildly from as low as 380.4 incidents per 100,000 to as high as 510.7 incidents per 100,000 people among our 50 states.

Today, utilizing that data from the CDC, which you can access here if you'd prefer to peruse it for yourself, we're going to look at the 10 states with the highest age-adjusted incidence rates of cancer, focus on some of the more common cancer types, and examine a few of the groundbreaking therapies that are on the market or being developed that could drastically change the outlook for cancer patients to positive.  

Here are the 10 states with the highest age-adjusted incidence rates of cancer:


Age-Adjusted Cancer Incidence Rate









New Hampshire






New York






Source: Centers for Disease Control and Prevention, rates per 100,000 people according to 2000 U.S. Census.

My intent is certainly not to alarm anyone, but there is a significant bias east of the Mississippi River when it comes to cancer rate incidence in the U.S. To add some context to the above figures, the average age-adjusted cancer incidence in this country is roughly 445 people per 100,000.

Source: Centers for Disease Control and Prevention.

Breaking down these figures
There are four particular cancer types that are diagnosed more in this country than any other form of cancer: prostate cancer in men, breast cancer in women, lung and bronchus cancer, and colorectal cancer.

As these states relate to prostate cancer incidence, five of the eight highest incidence states are listed above in Louisiana, Michigan, Delaware, New York, and New Hampshire. In female breast cancer, four of the aforementioned states are in the top nine -- Connecticut, Delaware, New Hampshire, and Iowa. The story is similar in colorectal cancer, with only Louisiana, Kentucky, and Iowa showing up within the top six incident rate states. Finally, three of the states above -- Kentucky, Maine, and Louisiana -- crack the top nine in terms of highest incidence for lung and bronchus cancer.

Clearly, there are a number of factors at work here, but I suspect obesity could be a prime one. WHO, the CDC, and the Mayo Clinic all list obesity as a major cancer-causing risk factor. In addition, obesity can lead to a number of other serious diseases such as type 2 diabetes and heart disease. As of 2010, as you can see below, three of these 10 states -- Louisiana, Kentucky, and Michigan -- all had obesity levels in excess of 30%, likely increasing their cancer incidence rates.

2010 U.S. obesity rates, Source: Centers for Disease Control and Prevention. 

Another prime cancer-causing factor that you'll see some commonality to in these states is smoking. According to a compilation from, Kentucky and Louisiana rank third and fourth in terms of the percentage of the adult population that smokes.There is perhaps no greater cancer-causing risk factor than tobacco products, so I feel pretty confident surmising that this is a reason why these aforementioned two states are among the highest in terms of cancer incidence rates in the country.

Battling the bulge
Now that we have a better understanding of where cancer incidence rates are the highest, and what some of the risk factors are that could be pushing these rates higher, let's examine a few therapies, both approved and in clinical studies, that could be used to win the war against cancer.

However, before I dive into three cancer therapies I'd suggest you have your eyes on, I think it prudent to mention, especially given how much of a risk factor obesity can be, that increasing awareness about obesity and obesity prevention could push physicians, consumers, and insurers toward a greater adoption of chronic weight management drugs over the coming years.

Both Arena Pharmaceuticals (NASDAQ: ARNA  ) and VIVUS have FDA-approved anti-obesity drugs already on the market in Belviq and Qsymia; however, sales of both has been nothing short of abysmal thus far. VIVUS' Qsymia was the first to reach pharmacy shelves and has delivered the greater percentage of weight loss in trials, yet Belviq offers the more favorable safety profile of the two drugs, making it the more logical choice, at least in my opinion, for physicians.

What investors and chronic weight sufferers will want to watch, though, is Orexigen Therapeutics (NASDAQ: OREX  ) , which has an experimental weight control drug known as Contrave currently under review by the FDA. Although weight control drugs are faring poorly, I believe a lot of this has to do with skepticism about their safety. Orexigen has already completed a study (the Light Study) involving 9,800-plus patients that demonstrated its drug is effective and safe over the long term without any serious adverse effects on the cardiovascular system. This alone could give Contrave an edge over its peers if it's approved, and go a long way to reducing obesity rates, and therefore cancer risk, in the United States.

Source: Novartis.

Breakthroughs on the cancer front
In addition to fighting high risk factors and encouraging Americans to alter poor lifestyle habits, biopharmaceutical companies are also tackling cancer with a myriad of groundbreaking drugs.

One, in particular, that I'd suggest keeping your eyes on is an experimental estrogen receptor positive, HER2-negative locally advanced or newly diagnosed metastatic breast cancer drug, palbociclib. Developed by Pfizer (NYSE: PFE  ) , and co-administered with Novartis' (NYSE: NVS  ) Femara, palbociclib was recently noted to have met its primary endpoint in the mid-stage PALOMA-1 study with detailed data to come at the American Association for Cancer Research annual meeting in April. Last year, however, the combination of palbociclib and Femara delivered early stage data which demonstrated progression-free survival had more than tripled to 26.1 months, compared with just 7.5 months for the Femara-only control arm. It's a very intriguing, and potentially life-altering drug for the most common type of breast cancer.

Another statistically impressive clinical therapy is LDK378, a breakthrough therapy designated non-small cell lung cancer drug from Novartis. In June, Novartis announced that LDK378 delivered an impressive 60% overall response rate among the 78 patients who were studied in ALK-positive NSCLC. Being the most common type of lung cancer, and delivering a superior overall response rate, this therapy could have the makings for an early approval in 2014.

Finally, turning toward an FDA-approved indication we have Medivation (NASDAQ: MDVN  ) and Astellas Pharma's Xtandi, a treatment for advanced-stage prostate cancer. There are, admittedly, a number of therapies on the market to treat this most common form of cancer, but Xtandi has stepped it up a notch with superior results in a pre-chemotherapy setting. In recently released final phase 3 results, Xtandi reduced the risk of death by 29% and the risk of radiographic progression by 81% in treatment-naïve patients. Perhaps most impressive, it delayed the start of chemotherapy in the Xtandi intent-to-treat group to 28 months compared to just 10.8 months in the placebo arm. Finally, the median time patients were able to take Xtandi was more than three times longer than the placebo (16.6 months versus 4.6 months), speaking to its impressive tolerability. Long story short, Xtandi looks like a game-changing drug in prostate cancer treatment.

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Read/Post Comments (18) | Recommend This Article (39)

Comments from our Foolish Readers

Help us keep this a respectfully Foolish area! This is a place for our readers to discuss, debate, and learn more about the Foolish investing topic you read about above. Help us keep it clean and safe. If you believe a comment is abusive or otherwise violates our Fool's Rules, please report it via the Report this Comment Report this Comment icon found on every comment.

  • Report this Comment On February 16, 2014, at 3:14 PM, vssnmb wrote:

    Cancer is not identified as an incidence. Hope whoever categorized it as that gets it and see how they feel then.

  • Report this Comment On February 16, 2014, at 4:36 PM, marliisa wrote:

    " three of these 10 states -- Louisiana, Kentucky, and Michigan -- all had obesity levels in excess of 30%, likely increasing their cancer incidence rates."

    --- Where is the correlation for this conclusion? It would be easy to find out if the people getting cancer belong to this obese 30% of population. Lots of people get cancer nowadays and the people I know who got cancer were not obese.

    So this article is just selling the drug companies...

  • Report this Comment On February 16, 2014, at 6:18 PM, monkeyfurball wrote:

    @marliisa: Read the book "The China Study". Watch the video "Forks Over Knives". Obesity contributes to cancer.

  • Report this Comment On February 16, 2014, at 7:09 PM, sv40researcher wrote:

    Not hard to figure out, compare the above list to a list of states where contaminated polio vaccines were given.

  • Report this Comment On February 16, 2014, at 8:30 PM, Vitabrits wrote:


    For some it is incidental. If you are pale white and are a "sun worshiper", you drastically increase your chances for skin cancer.

  • Report this Comment On February 16, 2014, at 8:32 PM, knight5thcav wrote:

    lol Kentucky Coal mining less on the Obesity

  • Report this Comment On February 16, 2014, at 10:37 PM, letstellthetruth wrote:

    I am so tired of everyone pointing to obesity. Obesity may be a cause, but it makes us stop looking at the things that we KNOW cause cancer. Air pollutions, plastics, coal mining, radiation. There are hundreds of plastics used in our food, yet something like 52 have been tested. Its time we get serious about fighting for the cause of cancer.

  • Report this Comment On February 17, 2014, at 12:06 AM, gazoo99 wrote:

    I see an author who just mentioned the names of ARNA, VVUS & OREX just to get his article read.....

  • Report this Comment On February 17, 2014, at 2:29 AM, solocodes wrote:

    Kentucky has a high incidence of smokers. Kentucky also has a high incidence of MS. I was raised on a farm in the state, back in the 50-60's, tobacco was the king cash crop. As a kid, I carried a doubletank sprayer of sucker control spray on my back as I walked through rows of tobacco that was over my head, no respirator, no mask, or airpack, no tee shirt even, due to the heat of summer. All these chemicals we sprayed on the crops ran into the ground, and then into the creeks, and into our groundwater, which fed our wells. DDT was still being used, even though the govt. said it was illegal. Gas station underground tanks were leaking, no one knew what it was doing to the groundwater.

    I have seen fishkills so bad they stopped up the intake valves at the water treatment plant, floating dead fish, what caused them to die? Chemicals discharged into the river from the whiskey distillery upriver. Cruise the river in a boat, and see the piles of household garbage dumped into erosion gullies along the river before we had scheduled garbage trucks in the rural areas. The runoff from these was small as individual sites, but when you find 100 of them, well it adds up. Then add in all the street and highway runoff chemicals that drain off the streets into the river directly, and you get the oil and gasoline byproducts MTBE etc. that fall out of our exhaust pipes of our vehicles.

    Why is there no incidences of cancer in areas where testing of atomic and nuclear weapons occurred? Maybe because those folks died years ago, but look at where the rates occur now, and see a heavy military presence of jobs, storage faciilities for nerve gas, mustard gas, old ammo storage plants, where it is not cost effective to destroy this stuff. We will never beat cancer, it is making too many people rich.

  • Report this Comment On February 17, 2014, at 4:51 AM, pokerpoodle wrote:

    Still the greatest risk for cancer is getting older. It is such a great risk, that it must be disregarded before we can talk about anything else. As we cut down on death rates from other diseases like heart attacks, we will have higher rates of cancer. No one, gets out of this life, alive. See Johnson, The Cancer Chronicles, Knoff, New York, 2013.

  • Report this Comment On February 17, 2014, at 7:56 AM, mvogell wrote:

    Too bad I don't smoke, don't drink, eat healthy and am not over weight. At lest then I'd have and excuse for the cancer. Maybe living in one of the listed states is enough.

  • Report this Comment On February 17, 2014, at 8:18 AM, stupidjerk wrote:

    Almost 100 years ago cancer's cause was found. Otto Warburg received a Nobel Prize for his work on cancer. There's only one prime cause of cancer. The loss of as little as 35% of the oxygen content of a cell can make it cancerous. Google his name and it's right there. Every type of cancer must lead back to the prime cause. All other causes are secondary causes like smoking, chemicals, radiation, etc. Once a cell becomes cancerous it cannot return to normal. Cancer is not genetic. Jolie wasted her time. Keeping your cells oxygenated will help prevent cancer. Warburg did not know how to do this. He knew that it would and subsequent experiments proved he was right. He has never been proven wrong. He has been credited as the greatest in his field. He was absolutely meticulous in his work. He spent his entire life as a hardcore scientist. Warburg states cancer is not genetic. Looking there is a waste of time. Dr. Weinberg who postulated the oncogene theory reversed himself years later. Modern work involves inflammatory states as they rob cells of oxygen to repair damaged cells in other parts of the body. The reason why breast cancer and prostate cancer is so prevalent is because they're not as important as vital organs and because of the fat content. One of the biggest cancer causing agents is eating processed oils. Their oxygen giving capabilities have been stripped. Also, these oils are a prime cause of heart disease. If any of you are interested google Brian Peskin for all this and more.

  • Report this Comment On February 17, 2014, at 8:29 AM, stupidjerk wrote:

    @ vitabrits,

    Stop blaming the sun for cancer. Blame fish oil instead.

    Not only does it increase the risk of prostate cancer but skin cancer too. Fish oil turns rancid immediately upon consumption. Also, it is loaded with 100 times the amount of derivatives the body makes and gets shoved in places where it isn't found like, your skin. Fish oil is also terrible for diabetics. Fish oil's claims are mostly unfounded.

  • Report this Comment On February 18, 2014, at 5:40 PM, bgabal wrote:

    If anyone cares to know the truth, cancer is almost definitely caused by an over-acidic condition of the body, which is usually systemic, like almost all other diseases. That occurs mostly from wrong foods, the worst being meat, dairy, eggs, refined sugar, refined grains, fried food, and probably table salt. Smoking also creates an acidic, inflammatory response. Our genetic weaknesses determine where we get the cancer or other disease, but we pull the trigger. The good news is that cancer and just about all other diseases, if not too far along, or treated to heavily by modern medicine, etc., is curable with an alkaline diet and detoxification. Robert Morse ND (YouTube and God's herbs website) has cured thousands upon thousands from anything from arthritis to M.S. using mostly fruit and herbs, and I myself am a proponent of fruitarianism (eating nothing but fruit). All diseases are curable, it has been proven time and time again. Look up the 80/10/10 diet and Robert Morse. God bless...

  • Report this Comment On February 20, 2014, at 5:01 PM, Shogun wrote:

    Why is there never any further mention of DCA - di chloro acetate? There was an article that some Canadians discovered that DCA CURED 70-80% of ALL cancers a few years ago... That 's right CURED as in totally got rid of...

    But, DCA is cheap, already produced, can't be patented, so it will never go through any testing here in the US because there's no bid money to be made from it.. Some physicians will prescribe it off-label.

    Google it and buy it from outside the country if you need. There's more information available about it online from people that have been using it now... It's not 100% effective, but I'll take 80% any day!

  • Report this Comment On January 04, 2015, at 1:37 PM, Marcello090 wrote:

    It seems that the states that contain the most nuclear power plants also have the highest cancer "incidences."

  • Report this Comment On April 10, 2015, at 10:03 AM, noone1974 wrote:

    I don't disagree with the cancer incidence rates listed. However, obesity should not be there. Look around in one of those cancer treatment centers, I don't remember seeing that many obese individuals in any of them, or maybe I just haven't seen them all. Some food for thought for some of you is research this: The EPA, CDC, ATSDR and various other government agencies and private agencies have a "listing", of what is "known Carcinogen(cancer-causing), mutagens and teratogens on their respective websites. Then go look up things like EPA violations on water quality and air quality reports and see how many of those heavy metals and carcinogens we consumed. Just in my state alone 2,871lbs of mercury contamination was leached into the environment by coal fired power plants. It only takes a 1/2 gram to contaminate a 10 acre area. Which incidentally is the same amount in a silver amalgam dental filling. The sources of contamination are so varied and broad there is no way to single out one source. Most doctors look at the obvious, diet, exercise, genetics, personal habits, but I wonder how much do look at environmental factors as well? I think this report is too biased and unfair.

    Thank you for allowing me to post. Have a great day. :)

  • Report this Comment On April 10, 2015, at 10:04 AM, noone1974 wrote:

    Oh yeah, 7 out of the 10 states with the highest cancer incidence did have operational nuclear reactors. While that statement is true, it is not conclusive with a direct cause.

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A Fool since 2010, and a graduate from UC San Diego with a B.A. in Economics, Sean specializes in the healthcare sector and in investment planning topics. You'll usually find him writing about Obamacare, marijuana, developing drugs, diagnostics, and medical devices, Social Security, taxes, or any number of other macroeconomic issues.

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