US Cancer Death Rate by State: A Map of the Burden

Cancer is the second-leading cause of death in the United States, but the risk of dying from it depends heavily on where you live. Age-adjusted cancer death rates vary by about 50% across states — from around 120 deaths per 100,000 in the lowest to about 180 in the highest. This guide maps the cancer death rate across the states, ranks them, and explains what drives the wide geographic gap.

How many people die of cancer?

Cancer accounts for roughly one in five U.S. deaths, second only to heart disease. The map above shows the age-adjusted cancer death rate by state — "age-adjusted" so that states with older populations aren't unfairly penalized in the comparison. Encouragingly, the national cancer death rate has fallen substantially over recent decades thanks to less smoking, earlier detection, and better treatment. But the burden remains deeply uneven across the country.

Which states have the highest cancer death rates?

The highest cancer death rates cluster in the South and Appalachia — Kentucky, West Virginia, Mississippi, and their neighbors — while the lowest are in the Mountain West (Utah, Colorado) and parts of the West. The gap between the highest- and lowest-rate states is striking, reflecting big differences in smoking rates, obesity, screening access, and the strength of local health-care systems. The ranking below lists every state.

Why cancer mortality varies by state

The single biggest driver is smoking — lung cancer remains the deadliest cancer, and states with historically high smoking rates have far higher cancer mortality. Obesity, which raises the risk of several cancers, plays a growing role. So does access to care: earlier screening and better treatment dramatically improve survival, so states with more uninsured residents and fewer specialists tend to fare worse. The same Southern and Appalachian states that rank high here also rank high on smoking and chronic disease generally.

What 'age-adjusted' means

Cancer is largely a disease of older age, so a state with many retirees would naturally have more cancer deaths per capita — which would make raw comparisons misleading. Age-adjustment mathematically standardizes every state to the same age structure, isolating the difference in risk from the difference in age. That's why these figures can be compared fairly across states, and why they reflect real differences in prevention, behavior, and care rather than just demographics.