In Iowa, Cancer Emerges as Bigger Midterm Issue Than Cost of Living

Iowa has the second-highest cancer rate in the nation and is one of only three states, along with Utah and West Virginia, where cancer incidence is rising, according to National Institute on Minority Health and Health Disparities data. Ahead of the November 3 midterm elections, in which Iowa could help decide control of Congress, candidates from both parties have made addressing the disease a top priority.

A survey found cancer ranks as the top issue facing the state, ahead of the cost of living. Republicans and Democrats agree the problem is serious but differ sharply on how much blame lies with Iowa's dominant farm economy.

"I think state leadership and industrial agriculture are very hesitant to have those conversations, but I think the Iowa public is calling and demanding action," said Sarah Green, executive director of the Iowa Environmental Council.

In the race for Iowa's open U.S. Senate seat, Democrat Josh Turek has highlighted his sister's breast cancer, while Republican Rep. Ashley Hinson has pointed to her health policy work in Washington. In the governor's race, Republican Zach Lahn and Democrat Rob Sand have each released plans to curb cancer rates.

Iowa's cancer rates tracked the national average until 2012, when they began climbing for reasons Green said remain unclear. In 2022, Iowa's overall cancer rate was about 506 cases per 100,000 people, compared with a national average of 442, according to National Institutes of Health data. The state also has elevated rates of non-Hodgkin lymphoma and acute myeloid leukemia, cancers some studies have linked to glyphosate, a widely used fertilizer marketed as Roundup.

Iowa is the nation's top producer of corn and pork and one of the largest soybean growers, with agriculture generating a third of the state's economic output. But farmers there use more fertilizer than those in any other state and operate the most concentrated animal feeding operations, which generate runoff. Green said Iowa has comparatively few regulations to keep pesticides and nitrate-heavy runoff from water supplies.

Last year, Des Moines' water utility issued its first-ever lawn watering ban after nitrate levels in the rivers supplying its water hit near-record highs; it rationed water again this summer.

Seth Watkins, a longtime farmer in southwest Iowa, said nearly every family on his road has dealt with cancer. "We have a farm policy that has resulted in less soil, less biodiversity, more cancer, fewer farmers and fewer opportunities," he said.

Green said her group's listening sessions last year found many Iowans considered the link between agriculture and cancer a "taboo" topic, and felt unsupported by state officials. Other factors include elevated radon exposure; this year Iowa's legislature approved a law requiring mitigation systems in new homes, and the GOP-led legislature approved $320 million toward water-related investments.