Cancer rates in southwest Iowa remain a concern
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By Olivia West
MOUNT AYR, Iowa — Cancer is not a disease that feels like a statistic in southwest Iowa. It’s a neighbor, a family member, a friend or someone who has spent years sitting in a doctor’s office waiting for test results.
The latest cancer data from the Iowa Cancer Registry shows that cancer remains a significant health concern in southwest Iowa, with Ringgold County’s overall cancer rate running higher than the statewide rate and its cancer death rate considerably higher.
The most recent five-year data, covering 2018 through 2022, shows Ringgold County had an age-adjusted incidence rate of 514.5 new cancer cases per 100,000 people. The Iowa rate was 498.8, while the national rate was 448.6. Ringgold County averaged about 39 new cancer cases each year during the five-year period.
The numbers are adjusted for age because cancer becomes more common as people get older. Age adjustment allows counties with different age distributions to be compared more fairly.
Ringgold County’s cancer incidence trend was classified as stable during the period studied. The Iowa Cancer Registry’s data does not show that the county is experiencing a rapidly increasing overall cancer rate.
The more troubling number is mortality. During the same 2018-2022 period, Ringgold County had an age-adjusted cancer death rate of 183.6 deaths per 100,000 people, compared with 149.6 for Iowa and 146.0 nationally. Ringgold averaged about 14 cancer deaths per year during those five years.
That difference does not necessarily mean southwest Iowa residents are developing cancer at dramatically higher rates than people that live in other counties. Cancer incidence and cancer mortality are two different measurements, and mortality can be affected by the type of cancer, the stage at which it is diagnosed and access to treatment.
It’s also important not to draw conclusions about the cause of the difference from county statistics alone. Iowa HHS specifically cautions that cancer data can show patterns and trends, but cannot determine what caused cancer in a particular community or individual.
Ringgold is not the only southwest Iowa county where cancer rates vary from the statewide picture.
In the same five-year period, Adams County had an overall cancer incidence rate of 513.7 per 100,000, while Union County was at 490.0. Montgomery County was at 505.8, Mills County at 483.2 and Clarke County at 457.0. Taylor County had a substantially lower incidence rate of 441.6. Fremont County was at 517.6 and Page County at 520.3.
The variation illustrates why looking at one county in isolation can be misleading.
Small rural counties also present a statistical challenge. A handful of additional cancer cases or deaths can cause a rate to move considerably from one period to another.
Lung cancer remains the state’s leading cause of cancer death. The Iowa Cancer Registry estimates 1,460 lung cancer deaths in 2026, followed by colorectal cancer with 550 deaths and pancreatic cancer with 530. About 175,290 cancer survivors are currently living in Iowa.
The state also faces a particular challenge because so much of Iowa is rural.
A recent Iowa HHS analysis found that nine of the 10 Iowa counties with the lowest colorectal and breast cancer screening rates are entirely rural. In those counties, nearly half of eligible residents had not received colorectal cancer screening and about 30 percent had not received breast cancer screening.
That does not mean the same percentages apply specifically to Ringgold County, but it does point to a larger rural-health issue: getting people screened and getting them into treatment can be more difficult when medical services are farther away.
Iowa has begun addressing that issue through its rural health transformation program, including a “Combat Cancer” initiative designed to expand screening, cancer treatment and supportive services in rural communities. Greater Regional Medical Center in Creston is among the facilities named as an Iowa cancer-care hub.
Not every cancer can be prevented, and not every cancer has an identifiable cause. Iowa HHS lists tobacco use, obesity, physical inactivity and sun exposure among major cancer risk factors, while genetic and environmental factors can also play a role. Early detection, however, can make a difference for several types of cancer.
Iowa recommends colorectal cancer screening beginning at age 45, and the state offers programs to help eligible residents obtain breast, cervical and colorectal screenings at reduced or no cost.
For a community such as Mount Ayr and the surrounding area, the statistics ultimately point to something fairly simple: cancer is not just a statewide problem.
It is something southwest Iowa families are dealing with every day.
The numbers cannot explain why one person gets cancer and another does not. They can, however, show where the burden is greatest and where prevention, screening and access to treatment may matter most.
And in a rural county where everyone seems to know someone who has battled cancer, those numbers are more than just numbers.
