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.

Image source: Getty Images.

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:

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.

Image source: Getty Images.

Another prime cancer-causing factor that you'll see some commonality to in these states is smoking. According to a compilation from Health.com, 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 (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.

Image source: Getty Images.

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 (PFE -1.49%), and co-administered with Novartis' (NVS 0.25%) 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 (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.