Iowa has the 2nd highest cancer incidence in the United States and the fastest growing rate of new cancers in the entire country.  Rural populations tend to experience greater cancer mortality than urban populations. In January 2025, Governor Reynolds asked the Iowa state legislature to appropriate $1 million to Iowa Department of Health and Human Services (HHS) to partner with the University of Iowa to identify the key drivers behind our continued presence as the second highest cancer incidence rate in the country. The College of Public Health has put together an interdisciplinary team of biostatisticians and epidemiologists as well as behavioral scientists to respond to this request which will provide information and guide the Department of Health and Human Services in developing targeted policies, enhancing prevention and screening programs, raising awareness and integrating evidence-based finding into existing initiatives. 

This project spans several goals, objectives, and strategies as described. The project, using data from the SEER Cancer Registry and from various data sources from Iowa Health and Human Services, such as the Behavior Risk Factor Surveillance Survey (BRFSS) and other data as is available, will use spatial analytic techniques to map current cancer rates to the zip code level for six identified cancers (prostate, breast, lung, melanoma, colorectal, HPV associated cancers) while controlling for known behavioral risk factors.  We will then identify geographic units (county or ZIP code) that have more cases than would be expected if Iowa followed national trends in cancer rates.  We will map cancer rates, create maps showing where cancer is most common in Iowa focused on the six identified cancer sites.

In addition, we will study prostate cancer screening by examining prostate cancer screening across the state to understand how following different screening guidelines might be associated with places in Iowa where we see higher prostate cancer rates. 

The team will review what works in other states by identifying successful cancer prevention programs, strategies and policies from other states that align with the risk factors identified by our research. We will assess how well these possible actions will work in Iowa. 

Identifying what is driving Iowa’s cancer rates is integral to determining the best prevention and intervention strategies to lower the risk of cancer for Iowan’s.