IOWA CITY — Booze may be helping fuel Iowa’s alarming cancer problem, along with smoking and obesity, as a major $1 million state investigation says researchers can now account for roughly 76% of Iowa’s excess cancer burden through behavioral and demographic factors.
Binge drinking, smoking and obesity emerged as key behavioral factors in the Cancer Drivers in Iowa project, a state-funded investigation undertaken by Iowa Health and Human Services and the University of Iowa College of Public Health as Iowa continues to suffer the second-highest rate of new cancer cases in the United States.
The findings are especially notable in a state where drinking is common. Iowa data have consistently shown binge drinking above the national rate, and researchers included alcohol consumption as one of the behavioral factors examined as they attempted to figure out why Iowans are developing cancer at such troubling rates.
But the researchers are not saying that booze, cigarettes and excess weight caused 76% of all cancers diagnosed in Iowa.
Instead, the study uses population-level statistical modeling to determine how much of Iowa’s “excess” cancer incidence — cancers beyond the number expected if Iowa experienced comparable national rates — can be accounted for by demographic and behavioral differences.
That distinction is important, but the findings nevertheless put several potentially preventable risk factors squarely in the spotlight.
Iowa’s cancer problem has been building for years.
NorthIowaToday.com reported in 2025 that Iowa continued to have the second-highest age-adjusted rate of newly diagnosed cancers in America and was one of only two states experiencing a rising age-adjusted rate of new cancers:
The latest Iowa Cancer Registry estimates indicate approximately 21,700 Iowans will be diagnosed with cancer during 2026 and about 6,400 will die from the disease. More than 175,000 cancer survivors are now living in Iowa.
More than one in 20 Iowans has experienced a cancer diagnosis.
The Cancer Drivers in Iowa project was launched after Gov. Kim Reynolds and state lawmakers approved $1 million for researchers to dig into what is behind Iowa’s unusually high and rising cancer incidence.
The project is examining behavioral factors such as smoking and drinking, environmental exposures such as radon and arsenic, and genetic factors that could contribute to cancer.
Researchers concentrated heavily on five common cancers that account for more than half of Iowa’s cancer cases: lung, melanoma, prostate, colorectal and female breast cancer.
Earlier work by the research team illustrated just how large Iowa’s cancer excess may be.
Using 2022 data, researchers estimated 2,582 additional cancer diagnoses among Iowans age 20 and older beyond the number that would have been expected if Iowa had experienced national cancer rates.
Those included approximately 400 excess melanoma cases, 376 excess lung cancers, 331 excess prostate cancers, 189 excess colorectal cancers and 141 excess female breast cancers.
Researchers then began asking a critical question: How much of that difference disappears when Iowa’s demographics and known cancer risk factors are taken into account?
The answer appears to be a lot.
Researchers say demographic and behavioral factors account for roughly 76% of Iowa’s excess cancer burden examined in the study, with obesity, binge drinking and smoking standing out among the behavioral factors.
The alcohol finding deserves particular attention.
Alcohol is a recognized cancer risk factor, and the connection extends well beyond liver cancer. Alcohol consumption increases the risk of cancers including breast, colorectal, liver, mouth, throat, larynx and esophagus cancers.
NIT previously reported on a U.S. Surgeon General warning that alcohol consumption is linked to at least seven types of cancer and a push for cancer warnings on alcoholic beverage labels:
Iowa has also historically had a bigger binge-drinking problem than the nation as a whole. Previous Iowa Cancer Registry presentations using 2022 estimates placed binge drinking among Iowa adults at about 21%, compared with approximately 17% nationally.
Obesity presents another substantial difference. The same data estimated approximately 37% of Iowa adults had a body mass index of 30 or higher, compared with roughly 33% nationally.
Smoking remains another major cancer risk despite substantial reductions in tobacco use over the decades.
Lung cancer provided researchers with one of the study’s most striking results.
After accounting for the variables examined — particularly Iowa smoking levels and potential radon exposure — researchers said Iowa’s statewide excess lung cancer cases could be statistically explained for both men and women.
That does not mean the lung cancer problem has disappeared.
Researchers still identified 13 Iowa counties where male lung cancer rates remained higher than expected, illustrating why statewide averages cannot answer every question about cancer occurring in individual Iowa communities.
Radon is particularly relevant in Iowa. The radioactive gas occurs naturally in soil and can accumulate inside homes, and long-term exposure is a known cause of lung cancer.
The research has implications for Northern Iowa as well.
Mason City state Rep. Christian Hermanson discussed the cancer investigation earlier this year after University of Iowa researchers presented preliminary findings to lawmakers. At that point, obesity, smoking and alcohol were already emerging as significant drivers while researchers acknowledged that Iowa’s departure from national cancer trends beginning around 2013 had not been completely explained.
NIT’s earlier report on Hermanson and Iowa’s cancer investigation can be read here:
One intriguing piece of Iowa’s cancer puzzle involves farmers.
The 2026 Cancer in Iowa report examined participants in the long-running Agricultural Health Study and found Iowa farmers in that study experienced about 13% fewer cancers overall than expected compared with Iowa’s general population after adjusting for age and sex.
Researchers said farmers had fewer-than-expected cases of several cancers, including lung, colorectal, bladder, liver and pancreatic cancer, although they experienced more prostate and lip cancers than expected.
Spouses of Iowa farmers in the study experienced about 10% fewer cancers overall than expected.
Researchers noted that Iowa farmers and their spouses reported lower smoking and alcohol use than the general population, which likely contributes to lower incidence of several cancers.
The agricultural findings do not settle the ongoing debate over environmental exposures.
The Agricultural Health Study has identified associations between some pesticides and increased risks for particular cancers among highly exposed farmers, and findings from that research have contributed to international evaluations of pesticides classified as known or probable carcinogens.
Determining whether an environmental exposure actually causes cancer, however, generally requires multiple studies and different kinds of evidence.
That issue looms large as the Cancer Drivers in Iowa project moves forward.
Environmental factors have generated intense interest in Iowa, where residents and researchers have raised questions about pesticides, agricultural chemicals, nitrate-contaminated water, radon and other exposures.
NIT reported on those concerns earlier this year as Reynolds signed Iowa’s “Farm to Faucet” water-quality legislation, which directs resources toward nitrate treatment, drinking-water infrastructure and expanded monitoring:
The new findings do not establish that environmental concerns are unfounded, nor do they demonstrate that a particular environmental exposure is responsible for Iowa’s overall cancer rate.
In fact, environmental factors are expected to receive greater scrutiny during the next phase of the state research, including examination of water quality.
That leaves an important portion of Iowa’s cancer excess still to be explained and significant questions about differences among individual counties.
State Medical Director Dr. Robert Kruse said the findings nevertheless provide evidence that Iowa does not have to wait for every remaining question to be answered before attacking known cancer risks.
Among the actions health officials are urging Iowans to take are reducing tobacco and alcohol consumption, maintaining a healthy weight, protecting against excessive ultraviolet exposure, testing homes for radon and obtaining recommended cancer screenings.
Researchers also caution against interpreting the project as identifying the cause of an individual Iowan’s cancer. Cancer can develop after complicated interactions among genetics, behavior, environmental exposures and other factors over many years or decades.
The Cancer Drivers in Iowa project itself describes cancer as a puzzle in which many different pieces can combine to increase risk.
What the $1 million investigation has now done is put considerably more of that puzzle together.
For Iowa — where approximately 21,700 people are expected to hear the words “you have cancer” this year — researchers say booze, smoking, obesity and other behavioral and demographic factors appear to explain a substantial share of the state’s cancer excess.
But the investigation isn’t finished.
The next phase will dig further into environmental factors and other unanswered questions as researchers continue trying to determine why Iowa remains one of America’s cancer hot spots.
The Cancer Drivers in Iowa project and its reports are available here:
And who funded the study?
Reynolds
Just remember. What comes out of your permitted septic tank goes right back into your private well. Now research that impact on your health.
Horse hockey.
You can’t be serious ? I’m appalled that NIT would even publish this type of false crap. Who assisted compiling all this false information , big ag, Farm Bureau, Kimmy & bird brain, & Grassley?? When are elected people in this state gonna fess up to the real cause of cancer in Iowa ? Never because most of them are farmers.
If it is all false, show us the truth and not as you see it.
Read other studies done that were not rigged by kimmy
Brandon won’t do that. He is a MAGA and doesn’t want facts but rather desires bs from the bs leader of his cult.
People like him have made this country into what it is today. With the help from our toddler president
Ease up. Youre gonna stroke out. Show us your research data.