According to data collected by the Centers for Disease Control and Prevention (CDC), the leading causes of cancer death are generally the same across the country. Lung cancers were the top cause in 45 states, and digestive system cancers (colon, stomach, pancreatic) were the leading cause in the other five. Although the leading causes were often the same, the mortality rates from these cancers varied significantly between states.

The most dramatic difference was in the lung cancer mortality rates in Kentucky and Utah — there were 76.1 age-adjusted lung cancer deaths per 100,000 people in Kentucky, three times the rate of 23.2 per 100,000 in Utah.

Click here to see the states with the highest cancer mortality rates.

Click here to see the states with the lowest cancer mortality rates.

While the mortality rates of other cancers also vary significantly across states, differences in the lung cancer mortality rate had the largest effect on the state’s rankings. The 10 states with the highest cancer mortality rates also had lung cancer death rates higher than the national average. While the 10 lowest states had rates below the national average.

The states with the highest incidence of new diagnoses did not necessarily have the highest cancer mortality rates, suggesting that other health risk factors such as access to care and healthy behaviors have a significant impact on cancer survival. Of the 10 states with the highest rates of cancer mortality,  six had below-average rates of incidence. Arkansas, which had the sixth-highest mortality rate, had the 11th lowest rate of new diagnoses per year.

Unhealthy behaviors contribute substantially to the incidence and mortality rates from cancer. For example, with lung cancer accounting for so large a portion of cancer deaths, smoking was an especially large factor. Nine of the 10 states with the highest cancer mortality rates also had among the 10 largest percentages of adults reporting a history of tobacco use.

Unhealthy behaviors, and the resulting higher mortality rates, are influenced by economic factors as well. Financial stability helps improve access to health care as well as healthier diets and exercise opportunities. The poverty rates in all 10 states with the highest cancer mortality rates were higher than the national poverty rate of 15.8%. While among states with the lowest cancer death rates, the opposite tended to be true.

Click here to see our full methodology.

These are the states where the most people are dying from cancer.

The States With the Highest Cancer Mortality Rates

10. Oklahoma
> Cancer mortality rate: 194.3 per 100,000
> Poverty rate: 16.8% (16th highest)
> Lung cancer mortality rate: 62.7 per 100,000 (8th highest)
> Pct. of population with smoking history: 24.1% (3rd highest)

Each year, for every 100,000 Oklahoma residents, 490 were diagnosed with cancer. The annual mortality rate from cancer-related complications was 194.3 deaths per 100,000 residents, the 10th-highest in the country and considerably higher than the national rate of 179 cancer deaths per 100,000 people. As in other states with especially high cancer-related death rates, Oklahoma residents had relatively unhealthy behaviors. The state had the third-highest prevalence of smoking history. Residents also had relatively poor access to healthy food, which likely contributed to unhealthy eating habits. Lung cancers contributed the most to Oklahoma’s high incidence of cancer.

ALSO READ: The Happiest Countries in the World

9. Ohio
> Cancer mortality rate: 194.5 per 100,000
> Poverty rate: 15.9% (22nd highest)
> Lung cancer mortality rate: 59.5 per 100,000 (12th highest)
> Pct. of population with smoking history: 21.2% (11th highest)

Ohio had the sixth most cancer deaths per year in the country, and is tied with Indiana for the ninth highest cancer-related mortality rate. While the state had a high prevalence of smoking history, it performed much better in other health risk factors, including having the 14th lowest rate of residents without health insurance, at 11%. Some cancers are more common than others. As in every other state with the highest cancer mortality rate, lung cancers were the largest contributors to the cancer death rate in Ohio. Also, the mortality rate from tonsil cancer was higher than the national rate.

8. Indiana
> Cancer mortality rate: 194.5 per 100,000
> Poverty rate: 90,422 16.0% (20th highest)
> Lung cancer mortality rate: 62.3 per 100,000 (9th highest)
> Pct. of population with smoking history: 22.8% (5th highest)

Indiana had the fifth highest rate of current or former smokers with 22.8% of adults having smoked at least 100 cigarettes over their lifetime. Relatively poor access to health care in the state also may have contributed to the high cancer death rate. There were 35.5 doctors per 100,000 people, versus the national rate of 46.1 doctors per 100,000 Americans. Despite having one of the 10-highest cancer mortality rates in the country, no single cancer had a rate that was more than 1.25 times the national rate. Lung and other respiratory cancer deaths occurred 1.2 times more frequently than the rest of the nation, or at 62.3 deaths per 100,000 people. The incidence of respiratory cancers in the state was 83.8 diagnoses per 100,000 people.

ALSO READ: The Countries With the Widest Gap Between the Rich and Poor

7. Alabama
> Cancer mortality rate: 198.7 per 100,000
> Poverty rate: 18.7% (7th highest)
> Lung cancer mortality rate: 62.9 per 100,000 (7th highesT)
> Pct. of population with smoking history: 21.9% (9th highest)

Alabama had the ninth highest rate of current or former smokers, with 21.9% of adults reporting they had smoked at least 100 cigarettes in their lifetimes. Like several other states with the highest cancer mortality rates, Alabama residents are not especially wealthy. The state’s poverty rate of 18.7% was the seventh highest nationwide. The states with the highest incidence of new diagnoses did not necessarily have the highest cancer mortality rate, suggesting that other health risk factors such as access to care and healthy behavior have a significant impact on cancer survival. Alabama, had the 16th lowest incidence of cancer diagnoses in the country, with 482.7 new diagnoses per 100,000 people annually. Yet, the state’s cancer-related mortality rate was the seventh highest in the nation.

6. Arkansas
> Cancer mortality rate: 200.7 per 100,000
> Poverty rate: 19.7% (4th highest)
> Lung cancer mortality rate: 67.4 per 100,000 (4th highest)
> Pct. of population with smoking history: 22.4% (8th highest)

Relatively unhealthy habits, poor economic factors, and low access to health care and healthy food options likely made surviving cancer much more difficult for many Arkansas residents. Nearly 33% of residents were obese, and more than 22% reported a history of tobacco use — both among the highest such rates in the nation. Also, nearly one in five residents lived in poverty, the fourth highest rate. The percentage of people unable to afford to see a doctor was eighth highest. Arkansas had a relatively low incidence of cancer diagnoses, despite the fact that more than 200 deaths per 100,000 people were associated with the disease, which was one of the highest mortality rates in the country. With 43 cancer deaths for every 100 cancer diagnoses, Arkansas had the worst cancer survival rate in the country.

5. Tennessee
> Cancer mortality rate: 201.9 per 100,000
> Poverty rate: 17.8% (12th highest)
> Lung cancer mortality rate: 67.5 per 100,000 (2nd highest)
> Pct. of population with smoking history: 22.6% (6th highest)

Tennessee reported a high prevalence of various health risk factors. The high rate of current and former smokers, the poor access to healthcare, and the high obesity rates all likely contributed to the state’s high cancer mortality rate. Mortality from acute monocytic leukemia, a form of blood cancer, was 1.56 times more common in Tennessee than it was nationwide. This cancer is linked to smoking, chemical and radiation exposures, and prior cancer treatments.

4. West Virginia
> Cancer mortality rate: 203.6 per 100,000
> Poverty rate: 18.5% (10th highest)
> Lung cancer mortality rate: 67.4 per 100,000 (3rd highest)
> Pct. of population with smoking history: 26.0% (the highest)

Like most states with high cancer mortality rates, West Virginia performed poorly in most health-related risk factors. It had the highest proportion of adults reporting a history of tobacco consumption, 26%, the third highest obesity rate, at 33.3% of adults, and the fourth highest proportion of residents who could not afford to visit a doctor, at 17.4%. Additionally, with the high employment in coal mining and other energy sector jobs, West Virginians have significant occupational exposure risk. There were more than 67 lung cancer-related deaths per 100,000 state residents, the largest contributor to the cancer mortality rate compared to other forms of cancer.

ALSO READ: States Where Incomes are Booming (or Not)

3. Mississippi
> Cancer mortality rate: 205.5 per 100,000
> Poverty rate: 19.8% (3rd highest)
> Lung cancer mortality rate: 66.5 per 100,000 (5th highest)
> Pct. of population with smoking history: 23.2% (4th highest)

More than 35% of adults in Mississippi were obese, and 24% of residents lived in poverty, each the highest rates in the country. Financial burdens made accessing health care far more difficult — nearly one in five residents said they could not see a doctor due to costs. There were also very few primary physicians in the state, with 26.5 doctors per 100,000 people, the lowest ratio nationwide. The chances of surviving cancer once diagnosed were also among the lowest in Mississippi, with 42 deaths occurring for every 100 diagnoses, the second-worst mortality-to-incidence ratio. Oral cancer mortality rate was more than three times higher than the national rate, and the mortality rate for bone cancer and some leukemias (blood cancers) were well more than twice the national average as well.

2. Louisiana
> Cancer mortality rate: 205.5 per 100,000
> Poverty rate: 24.0% (the highest)
> Lung cancer mortality rate: 63.2 per 100,000 (6th highest)
> Pct. of population with smoking history: 21.7% (10th highest)

Gulf coast neighbors, Louisiana and Mississippi shared the second highest cancer mortality rate in the countr. Louisiana ranks poorly in most health risk factors — it had the 10th highest rate of adults with a history of smoking and the second worst obesity rate. Residents in the state were much less likely to have access to nutritious food choices, with 9.7% of the population reporting such limited access, fourth worst in the country. Poverty is very high in the state, and residents were also among the most likely in the country to be unable to afford to go see a doctor. For every 100 people diagnosed with cancer in Louisiana, roughly 40 died, which was the eighth-worst mortality-to-incidence ratio in the country.

ALSO READ: The Most Unusual Deaths by State

1. Kentucky
> Cancer mortality rate: 211.7 per 100,000
> Poverty rate: 18.8% (6th highest)
> Lung cancer mortality rate: 76.1 per 100,000 (the highest)
> Pct. of population with smoking history: 25.6% (2nd highest)

Kentucky had the the highest cancer-related mortality rate in the country and the second highest overall incidence of cancer, with 537.9 new cases of cancer per 100,000 people each year, compared to the national incidence rate of 490.4. As in many other states where cancer deaths are relatively common, Kentucky residents reported relatively unhealthy habits. More than one-quarter of adults reported a history of tobacco consumption, the second-highest proportion. In addition, poor economic factors in the state, such as a poverty rate of nearly 19% — sixth highest — have likely made staying healthy a challenge for many residents. Nearly 17% of residents said they could not afford to see a doctor, the seventh highest such percentage. Potentially dangerous work environments were yet another risk factor for many Kentuckians. Workers in the state were more likely than most Americans to work in mining and other energy sector occupations, jobs that often involve exposure to higher levels of carcinogens and possible inhalants. The lung cancer mortality rate of 76.1 deaths per 100,000 people was the highest in the country, compared to the national average of 51.9.

The States With the Lowest Cancer Mortality Rates

10. New York
> Cancer mortality rate: 169.1 per 100,000
> Poverty rate: 16.0% (20th highest)
> Lung cancer mortality rate: 45.6 per 100,000 (40th highest)
> Pct. of population with smoking history: 16.6% (14th lowest)

New York had the ninth highest incidence of cancer in the country and the second-best mortality-to-incidence ratio, with just 32 deaths for every 100 new diagnoses per year over the reporting period, compared to 36.3 across the country. The state ranked well for many health risk factors, which could have contributed to the state’s lower cancer mortality rate. For example, just 2.5% of New York’s population had limited access to healthy food, the lowest proportion in the country. The state also had the seventh lowest obesity rate of 24.2%, and the eighth best ratio of primary care physicians per population. The highest relative cancer mortality rate in the state was from Kaposi Sarcoma, a disease closely linked to HIV/AIDS, and was 1.43 times higher than the national rate.

ALSO READ: The Most Expensive Places to Get Married

9. Wyoming
> Cancer mortality rate: 168.6 per 100,000
> Poverty rate: 10.9% (6th lowest)
> Lung cancer mortality rate: 43.9 per 100,000 (9th lowest)
> Pct. of population with smoking history: 19.8% (17th highest)

Wyoming‘s poverty rate of 10.9% was the sixth-lowest in the nation. Like several other states with especially low cancer death rates, relative financial stability may have helped Wyoming residents stay healthy. The state is far and away the largest producer of coal in the nation, accounting for nearly 40% of all U.S. production in 2012. However, unlike Kentucky and West Virginia — where the vast majority of coal miners work underground — 95.8% of those employed in coal mining in Wyoming work on the surface, significantly reducing the risk associated with such work. While nearly 20% of the population reported a history of smoking, a relatively high percentage, the mortality rate from lung cancers was 0.78 times the national average.

8. North Dakota
> Cancer mortality rate: 165.7 per 100,000
> Poverty rate: 11.8% (10th lowest)
> Lung cancer mortality rate: 43.6 per 100,000 (8th lowest)
> Pct. of population with smoking history: 18.1% (23rd highest)

Several economic factors in North Dakota may be contributing to the state’s low cancer mortality rate. North Dakota had the lowest percentage of people in the nation who could not afford to see a doctor, and the 10th lowest poverty rate. Cancers of the peritoneum, omentum, and mesentery (which are structures in and surrounding the abdomen) had a mortality rate 2.25 times higher than the national rate. The mortality rate of blood cancers in the state were much lower than the national rate.

ALSO READ: The Most Expensive Wars in U.S. History

7. Idaho
> Cancer mortality rate: 165.2 per 100,000
> Poverty rate: 15.6% (25th highest)
> Lung cancer mortality rate: 42.8 per 100,000 (6th lowest)
> Pct. of population with smoking history: 16.5% (13th lowest)

The incidence of cancers in Idaho was the 15th lowest in the nation at an age-adjusted 480.8 new diagnoses per 100,000 people each year. The mortality rate of cancer of the ureter, the part of the body that connects the kidneys and the bladder, was 1.86 times the national rate. Liver cancer, mostly associated with chronic alcohol use, had a mortality rate of only 0.65 times the national rate. In 2012, 14.5% of adults in the state reported drinking excessively in the past 30 days, one of the lower percentages nationwide.

6. California
> Cancer mortality rate: 162.8 per 100,000
> Poverty rate: 16.8% (16th highest)
> Lung cancer mortality rate: 40.8 per 100,000 (5th lowest)
> Pct. of population with smoking history: 12.9% (2nd lowest)

With the second lowest rate of former and current smokers, third lowest obesity rate, third lowest percentage of people with limited access to healthy food, California performed well for multiple health risk factors, which could contribute to the state’s low cancer mortality rate. However, some forms of cancer still hit California residents harder than others. The age-adjusted mortality rate for nasopharyngeal cancer (an area at the back of the passages through the nose) was 1.52 times the national average. This cancer is associated with Asian ancestry — and California has the second highest Asian population in the country after Hawaii.

5. Arizona
> Cancer mortality rate: 158.0 per 100,000
> Poverty rate: 18.6% (8th highest)
> Lung cancer mortality rate: 42.8 per 100,000 (7th lowest)
> Pct. of population with smoking history: 16.6% (14th lowest)

Like nearly all states with the lowest cancer-death rates, Arizona’s obesity rate of 23.9% was considerably lower than the national rate. The state had the eighth highest poverty rate, and the ninth highest percentage of adults without health insurance, however. Still, there were just 419 new cancer diagnoses per 100,000 Arizona residents in 2011, the lowest incidence in the nation. Death from all types of cancer was also far less common in Arizona than across the nation. However, mortality rates for other acute leukemias (a group of blood cancers) and cancer of the testicles were 1.36 and 1.25 times higher than the national rates, respectively. Meanwhile, cancer of the eye and the hypopharynx (an area at the back of the throat) were 0.5 and 0.42 times the national rate.

ALSO READ: 9 Old-Fashioned Names Making Huge Comebacks

4. New Mexico
> Cancer mortality rate: 157.4 per 100,000
> Poverty rate: 21.9% (2nd highest)
> Lung cancer mortality rate: 36.7 per 100,000 (2nd lowest)
> Pct. of population with smoking history: 18.7% (19th highest)

New Mexico had the fourth lowest obesity rate in the country, but unlike many states with low cancer mortality rates, it otherwise fared poorly in health-related statistics. State residents had the lowest access to healthy food, the fifth highest rate of uninsured, and the second highest poverty rate. Oropharyngeal cancer (the area at the back of the mouth) had an age-adjusted mortality rate that was half the national rate. These cancers are generally related to tobacco and alcohol use. The binge drinking rate for adults in New Mexico was 13.7%, which was the 10th lowest rate in the nation.

3. Colorado
> Cancer mortality rate: 154.8 per 100,000
> Poverty rate: 13.0% (16th lowest)
> Lung cancer mortality rate: 38.3 per 100,000 (4th lowest)
> Pct. of population with smoking history: 16.9% (18th lowest)

Colorado had the highest percentage of adults reporting regular physical exercise, which likely helped state residents stay healthy. The state had the lowest obesity rate in the country at 20.4%. Given the risk of multiple cancers, including breast and colon, linked to obesity (roughly 5% of all cancer diagnoses), the low obesity rate in the state likely contributes significantly to its low cancer incidence and mortality rate. The incidence of all cancers in the state was 458.4 new diagnoses per 100,000 people, sixth lowest in the nation. The mortality rate from melanoma, a type of skin cancer, was 1.23 times the national rate. This could be partly due to increased sun exposure from the higher elevation and more time spent outdoors exercising. Cancers of the urinary system, multiple throat cancer types (laryngeal, hypopharyngeal, and tonsillar), and penile cancer had mortality rates below 0.7 times the national rate.

ALSO READ: The 10 Richest Towns in America

2. Hawaii
> Cancer mortality rate: 145.6 per 100,000
> Poverty rate: 10.8% (5th lowest)
> Lung cancer mortality rate: 37.9 per 100,000 (3rd lowest)
> Pct. of population with smoking history: 15.3% (5th lowest)

Hawaii performed extremely well in most health-related factors. It had an above-average number of primary care physicians per capita, the second lowest obesity rate and uninsured rate, the third lowest percentage of people unable to afford to see a doctor, and the fifth lowest proportion of adults reporting a history of tobacco use. In Hawaii, chronic lymphocytic leukemia, a cancer of the blood, had an age-adjusted mortality rate only 0.34 times the national rate.

1. Utah
> Cancer mortality rate: 133.8 per 100,000
> Poverty rate: 12.7% (14th lowest)
> Lung cancer mortality rate: 23.2 per 100,000 (the lowest)
> Pct. of population with smoking history: 9.4% (the lowest)

Less than 10% of Utah adults reported a history of tobacco use, the lowest in the nation and the only percentage not to exceed 10%. With so few residents smoking, It is unsurprising that Utah had the lowest cancer mortality rate. According to the CDC, cigarette smoking causes about one-fifth of all deaths annually — not just from cancer — in the United States, and it is associated with a 23-fold higher risk of death from lung cancer in men and a 13-fold higher risk in women. In Utah, the risk of death from lung cancers was 0.45 times the national average, or roughly 29 fewer deaths per 100,000 people. Laryngeal cancer, also highly associated with smoking, had an age-adjusted mortality rate 0.34 times the national rate.

Methodology

To identify the states with the most (and least) people dying from cancer, 24/7 Wall St. reviewed annual average age-adjusted cancer mortality rates in each state for the period from 2004 through 2010 based on data from the CDC WONDER tool. We also reviewed the age-adjusted incidence of new cancer diagnoses in each state from the same period. We also looked at mortality and incidence rates for specific types of cancer.

To measure how likely death and diagnoses of each cancer type was in each state relative to the nation as a whole, we calculated a location quotient for each cancer type. In addition, we computed the mortality-to-incidence ratio as a proxy for survival rates in each state, a widely used statistic in population-based studies on cancer survival. It is the mortality rate for a specific cancer in a state divided by its incidence rate.

We also considered the share of adults who have smoked at least 100 cigarettes in their lifetime and the share of residents who could not see a doctor because of costs from the CDC’s Behavioral Risk Factor Surveillance System. The percentage of adults who were obese, the percentage of adults meeting certain exercise requirements in 2013, and the number of primary care providers per 100,000 people in 2012 also came from the CDC. From the U.S. Census Bureau’s 2013 American Community Survey, we considered the proportion of the population without health insurance and each state’s poverty rate. The share of the population with limited access to healthy food in 2012 came from the United States Department of Agriculture (USDA). Occupational data for 2014 came from the Bureau of Labor Statistics.

Thank you for reading! Have some feedback for us?
Contact the 24/7 Wall St. editorial team.