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Pacing a stage at the Iowa State Fair, flanked by his wife and four of their six children, Republican US Congressman Zach Nunn spoke passionately about an issue that has emerged as a key concern in his competitive midterms race: cancer.<\/strong><\/p>\n \u201cLook, my mom is a survivor. I know that it has touched all of us, our family, our friends,\u201d he said at the August event, touting his efforts to bring more money for cancer screening to Iowa\u2019s third congressional district.<\/p>\n Two days before, his Democratic challenger in November\u2019s election, state \u200bSenator Sarah Trone Garriott, had discussed cancer on the same stage.<\/p>\n \u201cWe know Iowa has a cancer problem. All of us have friends, neighbors, maybe we\u2019ve even experienced it ourselves,\u201d she said.<\/p>\n They were not the only hopefuls to talk about \u200cit: five of the six House, Senate and gubernatorial candidates who appeared at the fair discussed Iowa\u2019s high cancer rates, reflecting the extent to which the disease has become a bipartisan campaign issue this year.<\/p>\n Candidates, advocacy groups and strategists say the state\u2019s rising cancer rate \u2013 the second highest in the country behind Kentucky \u2013 has for the first time emerged as a major issue alongside kitchen-table concerns such as the cost of living.<\/p>\n While the causes of cancer are often complex and not well understood, Iowa voters\u2019 concerns are driven in part by worries that the state\u2019s worsening water pollution from nitrates and other chemicals may be to blame for a spike in cases. The candidates have pledged a range of \u200bactions from increasing cancer screening to improving water quality monitoring. Democrats have used the issue to push for expanded healthcare access, while Republicans have promoted greater treatment options and research funding.<\/p>\n After more than a decade \u2060of decline, Iowa\u2019s cancer rate began to rise in 2014, and it has had the second-highest cancer rate in the nation since 2023, according to reports by the Iowa Cancer Registry, which tracks and studies cancer cases among Iowans.<\/p>\n It is one of just three states where cancer \u200bis rising, driven by higher rates of lung, prostate and breast cancers, among others, according to the National Cancer Institute at the National Institutes of Health.<\/p>\n Tim Hagle, a political scientist at the University of Iowa, said he can\u2019t remember cancer ever being such a significant concern in past elections. \u200bThe issue has taken hold in part this year because it ties into voter concern about other health issues, like Republican-backed cuts to Medicaid, the federal health program for lower-income Americans, he said.<\/p>\n Some Democrats are using the focus on cancer to attack incumbent Republicans for supporting President Donald Trump\u2019s 2025 tax and spending law, which made cuts to Medicaid by expanding work requirements for beneficiaries, among other changes.<\/p>\n Josh Turek, a Democrat running for Senate, in his remarks at the Iowa State Fair criticized his Republican opponent Ashley Hinson, who represents Iowa\u2019s second congressional district, for \u201c(voting) for 110,000 Iowans to lose their healthcare in a state with a cancer \u200band a healthcare crisis.\u201d<\/p>\n Independent health policy research group KFF estimates that around 100,000 Iowans could lose health insurance by 2034 due to changes under Trump\u2019s tax and spending law.<\/p>\n Hinson pointed to her support for legislation that would improve access to mobile cancer screening and mammogram machines in rural \u200bareas, and for conservation efforts to improve water quality.<\/p>\n \u201cI have lost two aunts and my grandmother to cancer. It\u2019s personal to me,\u201d she said in an email to Reuters. Iowa\u2019s chapter of the American Cancer Society Cancer Action Network, which advocates for policies to end cancer, says voters are more engaged on the issue and that all are raising the question of whether water quality is linked to cancer rates.<\/p>\n \u201c(It) is top of mind for everybody,\u201d government relations director Jackie Cale said, adding that the causes of cancer are complex and not limited to just one thing.<\/p>\n A July poll conducted by GQR, a polling firm that works with Democrats, on behalf of the Johns Hopkins Center for a Livable Future, a public health center focused on agriculture, found that 60% of 800 likely Iowa voters ranked water quality among their top five issues in the November elections.<\/p>\n Many Iowans tie their cancer concerns to high nitrate levels in the state\u2019s water, which can occur when fertilizer washes into rivers and groundwater. About \u200b85% of Iowa is farmland, much of it dedicated to fertilizer-heavy crops \u200blike corn, according to the US Department of Agriculture.<\/p>\n The concentration \u2060of nitrates in Iowa\u2019s main waterways doubled over the past 50 years and regularly exceeds levels set by the Environmental Protection Agency, according to a 2025 statewide report commissioned by Iowa\u2019s Polk County Board of Supervisors.<\/p>\n The Fertilizer Institute, an industry trade group, declined to comment for this story.<\/p>\n Scientists have not reached a consensus on the cancer risk posed by nitrate-contaminated drinking water. Some studies, including by the University of Iowa and the National Cancer \u200bInstitute, have found associations with higher cancer rates or mortality, while others have not.<\/p>\n Outgoing Republican Governor Kim Reynolds in 2025 commissioned a two-year study by the state\u2019s Department of Health and Human Services and the University \u200bof Iowa to examine why the state \u2060has seen such a rise in cancer.<\/p>\n An interim report released in February found that Iowa has similar demographic and behavioral risk factors as neighboring states, though it is among the highest-ranked states in cancer risk factors like binge drinking and obesity. The report did not provide firm conclusions about the rise.<\/p>\n The Iowa Farmers Union said concerns about possible links between cancer, contaminated water and pesticide use are a recurring theme in discussions with rural Iowans.<\/p>\n The group\u2019s president, Aaron Lehman, told Reuters that the focus should be on expanding farmers\u2019 options to reduce runoff and improve water quality, while holding all parts of \u2060the agricultural system \u200baccountable and placing producers at the center of any long-term solution.<\/p>\n Iowa has attempted to reduce runoff through its 2013 Nutrient Reduction Strategy, which aimed to curb pollution into the \u200bMississippi River, but environmental groups and the Iowa Farmers Union have said the voluntary plan hasn\u2019t done enough.<\/p>\n The uncertainty over the cause of the increase in the cancer rate has not diminished voter concerns. During a five-county tour this August, Bohannan, the Democratic candidate, said voters worried about the rise of cancer cases told her water quality was \u200bamong their top issues.<\/p>\n \u201cI talked to water treatment plant operators, people involved in conservation, I talked to everyday people, parents who are worried about the water with their kids,\u201d she said. \u201cIt is definitely becoming a major issue.\u201d<\/p>\n<\/div>\n
Every \u200bmajor candidate in Iowa\u2019s competitive races for Congress and the state governorship has talked about their plans to tackle cancer in recent speeches, social media posts or on their websites, according to a Reuters review of campaign materials.<\/p>\nTHE POLITICS OF CANCER<\/strong><\/h3>\n
Turek and other Democrats, like Christina Bohannan, who is running in Iowa\u2019s first district, have said they would push to reverse those cuts \u200cand campaign for further \u2060federal investment in cancer research.<\/p>\nTHE SCIENCE<\/strong><\/h3>\n