Iowa’s cancer rate is the second highest in the nation, behind only Kentucky, and the evidence shows it’s not just one thing that’s causing that rate to be higher, but a mountain of pebbles helping to create those higher rates.
Dr. Sarah Nash with the Iowa Cancer Registry spoke about that ongoing cancer rate, factors that contribute to cancer and other items at a speech at Lester Buresh Family Community Wellness Center Thursday, May 8. Nash said one of the findings that the Iowa Cancer Registry has determined is that cancer rates have steadily risen in the state since 2013. That’s for all cancers.
Iowa does have higher percentages of melanoma, breast, prostate and lung cancers that are driving cancer rates higher in the state.
Nash said that when the cancer rates are compared to the states around Iowa, it shows it is definitely something unique to the state of Iowa currently.
“It’s not something that we just did in 2013,” Nash said. “Cancer is one of those illnesses that takes a long time to develop. The patterns we’re seeing today are a reflection of things we’ve possibly done 20 to 30 years ago, and it’s going to take a lot of effort and time to turn this ship back around.”
Nash said that breast cancer rates are higher in urban areas, which comes from later childbearing years and higher rates of education. Rates of lung cancer are higher along the swath of counties in the south of the state. Prostate cancer rates are much higher in the northwest portion of the state, and Nash wondered if that might not be related to more PSA testing done in those areas.
Melanoma cases are much higher in the northern swath of counties in the state.
“We think that’s related to so many farmers in those areas and not wearing adequate sun protection,” Nash said.
On the positive side is while Iowa’s cancer rates are high, Iowa’s mortality rate is right in the middle of the pack.
“For every person who has a diagnosis, there is a level of treatment and survivorship,” Nash said. “It’s great that we have mortality declining, but it still leaves a large number of people being diagnosed with cancer.”
An attendee has asked if there is just better methodology in reporting of cancer over the years.
Nash said that has changed, but not enough to account for the rates we are seeing.
Another attendee wondered if diet for some people had a higher contribution to cancer diagnosis.
Nash said as someone who was in epidemiological research that answer falls into an ecological fallacy, where focusing just on diet alone skews research, when there are a number of factors controllable and uncontrollable that contribute to cancer diagnosis.
David Osterberg wondered if the counts for cancer diagnoses can be skewed due to lower population numbers in certain Iowa counties, like Cass being a high area for all cancers when its population is less than 6,000 citizens total.
Nash said when statistics are too low, it does pose a problem, especially for rarer cancers.
Nash said that the important thing to remember is it’s not just one cause of cancer, most people encounter it from a combination of different genetic, lifestyle, environmental and structural risk factors that change the function of cells in their body.
Lifestyle factors include tobacco, alcohol use (especially binge drinking), an unhealthy diet, not being physically active and sunburns.
Environmental includes exposure to chemicals and radiation.
That led to discussion with attendees on why data isn’t collected on radon and other exposures by the Iowa Cancer Registry.
Nash said they rely on other researchers collecting that data to help their own pool sets, that they aren’t the experts in those fields. Nitrates is a portion of study that will come in the next year’s study from the Iowa Cancer Registry.
Nash said risk factors can take years between exposure and a cancer to develop, which also makes it more difficult to prove the connection.
“The important things to do are to reduce your cancer risk by limiting your risk factors whenever possible,” Nash said. “Focus on the things you can do to reduce your cancer risk.”
A question came on Iowa Cancer Registry’s funding streams. Nash said a majority of their budget does come from federal government, and a request to reduce the budget by 40 percent was made. In Iowa, they will be receiving $1 million in the budget to look at why cancer rates are increasing in Iowa.
“It’s going to take a lot more than one time money and one time investment on this issue,” Nash said. “It’s going to take a lot more money and a lot more people.”
She encouraged Iowans to continue to talk to their legislators about the importance of bills they are passing that will impact cancer rates.
She also encouraged people interested in cancer in Iowa to sign up for the upcoming Iowa Cancer Symposium being held in Linn County, either virtually or in person. Information on that event can be found at https://shri.public-health.uiowa.edu/cancer-data/cancer-in-iowa-99-counties-project/. The event is slated for Thursday, May 29, at 10 a.m.