Which states have the highest cancer rates?

While cancer mortality has dropped across all states over the last 25 years, Kentucky topped the charts for new cases in 2022 and deaths in 2023.

Updated Dec 29, 2025by the USAFacts team

In 2022, Kentucky had the highest incidence rate of age-adjusted new cancer cases nationwide at 512.0 per 100,000 people, 15.8% above the national rate, followed by West Virginia (510.6) and Iowa (505.9). New Mexico had the lowest rate of any state (366.9) and was followed by Massachusetts (377.9) and Colorado (382.2).

According to Centers for Disease Control and Prevention (CDC) data, the nationwide cancer incidence rate was 442.3 per 100,000 people.

Separately, Puerto Rico had the lowest rate of new cancers and mortality compared to the states. (The CDC has collected cancer data for Puerto Rico since 2005, but it is not included in the national incident rate. The CDC also has limited data for other US territories.)

Kentucky had the highest rate of new cancer cases — New Mexico the lowest.

New cases of cancer per 100,000 people, age-adjusted, 2022

Data for American Samoa, Guam, the Northern Mariana Islands, and the US Virgin Islands was not reported by the CDC. Data for Puerto Rico is not included in the national incidence rate.

Over time, the national cancer incidence rate has decreased by 8.1% over 24 –years, from 481.1 per 100,000 in 1999 to 442.3 in 2022. However, rates have risen in ten states, with the largest increases in Tennessee (13.5%), Minnesota (6.5%), and North Carolina (5.8%).

The biggest decreases in the rate of new cases occurred in Massachusetts (-24.8%), Oregon (-21.2%), and Rhode Island (-21.0%). Washington, DC had a decline of -26.4%.

The rate of new cancer diagnoses increased in 10 states from 1999 to 2022.

New cases of cancer per 100,000 people, age-adjusted, 1999–2022

Data for 1999 unavailable for three locales: South Dakota data begins in 2001, Mississippi in 2003, and Puerto Rico in 2005

Which states have the highest rate of cancer deaths?

Kentucky had the highest age-adjusted cancer mortality rate in 2023: 181.1 per 100,000 people, 28.0% above the national rate (141.5). It was followed by West Virginia (172.0) and Mississippi (171.5).

Hawaii had the lowest rate at 118.5 cancer deaths per 100,000 people, followed by New York (120.3) and Utah (122.5).

Kentucky had highest rate of cancer deaths — Hawaii the lowest.

Cancer mortality rate per 100,000 people, age-adjusted, 2023

Data for American Samoa, Guam, the Northern Mariana Islands, and the US Virgin Islands was not reported by the CDC. Data for Puerto Rico is not included in the national incidence rate.

Mortality has decreased in every state over the 25-year period between 1999 and 2023. Nationally, the rate fell from 200.7 deaths per 100,000 people in 1999 to 141.5 in 2023, a drop of 29.5%. Oklahoma had the smallest decline (-18.9%), followed by Kentucky (-19.3%) and Nebraska (-20.8%).

The rate of cancer deaths fell the most in New Jersey (-40.6%), New York (-38.7%) and Massachusetts (-35.5%). Washington, DC had a decline of 45.8%.

Cancer deaths dropped by at least 25% in 35 states and Washington, DC.

Cancer deaths per 100,000 people, age-adjusted, 1999–2023

Puerto Rico data begins in 2005.

Why do cancer rates vary by state?

There are many factors that influence US cancer rates, including:

  • Demographic factors: The likelihood of having cancer increases with age, and men have a higher rates of cancer diagnosis and mortality than women.
  • Racial and ethnic identities: Cancer rates vary by racial and ethnic groups.
  • Behavioral patterns: Smoking, diet and exercise influence health outcomes.
  • Healthcare accessibility: People who have regular screenings are more likely to survive due to early-stage detection.

While age-adjusted rates enable comparisons across states, 73% of all cancer diagnoses in 2022 and 86% of all cancer deaths in 2023 occurred among people ages 60+. As a result of older populations accounting for most cases, age could also lead to regional variations, even after adjusting for age in the data.

Racial and ethnic data show differences between cancer rates and types among certain groups. For instance, non-Hispanic Black women are 41% more likely to die of breast cancer compared to the national rate despite having a 1% lower incidence rate. Non-Hispanic Black men die of prostate cancer at nearly twice the national rate.

Lifestyle choices matter, too — particularly smoking. States with higher smoking prevalence tend to have increased rates of tobacco-associated cancers, such as lung cancer.

Healthcare access may also play a role: states with lower insurance coverage rates can lead to disparities in preventative screenings needed to combat cancer in its early stages. Regular screenings for breast cancer, for example, have reduced breast cancer death by 26%.

By recognizing the multifaceted nature of factors influencing cancer rates, policymakers and public health officials can develop evidence-based strategies to address disparities and reduce the overall burden of cancer across states.


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