Cancer was the second-leading cause of death, after heart disease, in the United States in 2020, according to the Centers for Disease Control and Prevention. There were 602,350 cancer fatalities in the U.S. in 2020.
Lung cancer was the leading cause of cancer death, accounting for 23% of all cancer deaths, followed by cancers of the colon and rectum (9%), pancreas (8%), female breast (7%) and liver and intrahepatic bile duct (5%), according to the CDC. More males died from lung, colorectal, and pancreatic cancer than females.
Unfortunately, cancer death rates are higher in some parts of the country than others. (Cancer incidence also varies by state. This is the state where the most people are getting cancer.)
To find the states where the most people die of cancer, 24/7 Tempo reviewed cancer mortality statistics by state for 2020 from the Centers for Disease Control and Prevention. States were ranked by the age-adjusted cancer death rate – i.e. cancer deaths per 100,000 population.
We also included adult smoking, obesity, and inactivity rates for 2020 from County Health Rankings & Roadmaps, a program of the University of Wisconsin Population Health Institute and Robert Wood Johnson Foundation. Median household income figures are five-year estimates for 2020 from the Census Bureau American Community Survey.
States with higher levels of smoking, obesity, and inactivity rates, as well as low median household incomes, tend to have higher cancer death rates. Many of the states that have higher obesity and inactivity rates and lower median household income are in the South and the Rust Belt. Some of the states with elevated smoking levels are states that grow the most tobacco such as Kentucky and Tennessee. (More locally, this is the county with the highest smoking rate in every state.)
States with fewer cancer death rates are mostly in the West: California, Arizona, Utah, Colorado, and New Mexico. Nine of the 10 states with the lowest cancer death rates also have among the 10 lowest smoking rates.
There is good news in the fight against cancer. From 2001 to 2020, cancer death rates declined 27%, from 196.5 deaths per 100,000 population to 144.1 deaths per 100,000. The CDC attributes the drop to public campaigns about the health risks of using tobacco, cancer vaccines, diagnostic practices, and screening tests.
Click here to see the states where the most people die of cancer
50. Utah
> Cancer deaths per 100,000: 119.5 (3,460 – 13th lowest)
> Smoking rate: 8.9% (the lowest)
> Obesity rate: 25.9% (9th lowest)
> Inactivity rate: 18.1% (5th lowest)
> Median household income: $74,197 (12th highest)
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49. Hawaii
> Cancer deaths per 100,000: 123.8 (2,519 – 9th lowest)
> Smoking rate: 12.8% (4th lowest)
> Obesity rate: 23.7% (3rd lowest)
> Inactivity rate: 20.5% (11th lowest)
> Median household income: $83,173 (4th highest)
48. Colorado
> Cancer deaths per 100,000: 127.2 (8,252 – 23rd lowest)
> Smoking rate: 14.6% (12th lowest)
> Obesity rate: 21.8% (the lowest)
> Inactivity rate: 15.5% (the lowest)
> Median household income: $75,231 (11th highest)
47. Arizona
> Cancer deaths per 100,000: 127.7 (12,676 – 17th highest)
> Smoking rate: 15.6% (16th lowest)
> Obesity rate: 27.5% (14th lowest)
> Inactivity rate: 21.8% (19th lowest)
> Median household income: $61,529 (23rd lowest)
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46. New York
> Cancer deaths per 100,000: 128.8 (32,955 – 4th highest)
> Smoking rate: 14.1% (9th lowest)
> Obesity rate: 25.5% (5th lowest)
> Inactivity rate: 24.7% (18th highest)
> Median household income: $71,117 (14th highest)
45. New Mexico
> Cancer deaths per 100,000: 129.8 (3,649 – 15th lowest)
> Smoking rate: 17.5% (20th highest)
> Obesity rate: 26.6% (13th lowest)
> Inactivity rate: 19.7% (7th lowest)
> Median household income: $51,243 (5th lowest)
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44. California
> Cancer deaths per 100,000: 130.3 (59,778 – the highest)
> Smoking rate: 11.3% (2nd lowest)
> Obesity rate: 23.6% (2nd lowest)
> Inactivity rate: 17.6% (4th lowest)
> Median household income: $78,672 (6th highest)
43. New Jersey
> Cancer deaths per 100,000: 133.4 (15,576 – 11th highest)
> Smoking rate: 13.7% (7th lowest)
> Obesity rate: 26.4% (11th lowest)
> Inactivity rate: 26.0% (13th highest)
> Median household income: $85,245 (2nd highest)
42. Connecticut
> Cancer deaths per 100,000: 133.8 (6,638 – 22nd lowest)
> Smoking rate: 12.7% (3rd lowest)
> Obesity rate: 25.8% (8th lowest)
> Inactivity rate: 20.4% (10th lowest)
> Median household income: $79,855 (5th highest)
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41. Massachusetts
> Cancer deaths per 100,000: 135.2 (12,376 – 18th highest)
> Smoking rate: 13.7% (6th lowest)
> Obesity rate: 24.7% (4th lowest)
> Inactivity rate: 21.3% (15th lowest)
> Median household income: $84,385 (3rd highest)
39. Florida
> Cancer deaths per 100,000: 136.3 (45,800 – 2nd highest)
> Smoking rate: 16.1% (22nd lowest)
> Obesity rate: 26.6% (12th lowest)
> Inactivity rate: 25.9% (15th highest)
> Median household income: $57,703 (14th lowest)
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39. Wyoming
> Cancer deaths per 100,000: 136.3 (1,029 – the lowest)
> Smoking rate: 18.7% (17th highest)
> Obesity rate: 28.9% (20th lowest)
> Inactivity rate: 24.1% (22nd highest)
> Median household income: $65,304 (20th highest)
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38. Idaho
> Cancer deaths per 100,000: 136.5 (3,004 – 11th lowest)
> Smoking rate: 14.3% (10th lowest)
> Obesity rate: 29.3% (21st lowest)
> Inactivity rate: 20.8% (13th lowest)
> Median household income: $58,915 (17th lowest)
36. Minnesota
> Cancer deaths per 100,000: 138.7 (9,944 – 24th highest)
> Smoking rate: 14.5% (11th lowest)
> Obesity rate: 27.9% (16th lowest)
> Inactivity rate: 20.1% (9th lowest)
> Median household income: $73,382 (13th highest)
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36. Washington
> Cancer deaths per 100,000: 138.7 (12,796 – 16th highest)
> Smoking rate: 13.5% (5th lowest)
> Obesity rate: 27.8% (15th lowest)
> Inactivity rate: 17.0% (2nd lowest)
> Median household income: $77,006 (9th highest)
35. North Dakota
> Cancer deaths per 100,000: 139.5 (1,308 – 3rd lowest)
> Smoking rate: 18.3% (18th highest)
> Obesity rate: 32.7% (13th highest)
> Inactivity rate: 23.9% (23rd highest)
> Median household income: $65,315 (19th highest)
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34. Texas
> Cancer deaths per 100,000: 139.8 (42,142 – 3rd highest)
> Smoking rate: 15.7% (18th lowest)
> Obesity rate: 30.1% (25th lowest)
> Inactivity rate: 24.4% (20th highest)
> Median household income: $63,826 (21st highest)
33. Montana
> Cancer deaths per 100,000: 141.5 (2,138 – 7th lowest)
> Smoking rate: 17.2% (25th highest)
> Obesity rate: 25.8% (7th lowest)
> Inactivity rate: 21.6% (18th lowest)
> Median household income: $56,539 (11th lowest)
32. Rhode Island
> Cancer deaths per 100,000: 141.6 (2,076 – 6th lowest)
> Smoking rate: 14.9% (13th lowest)
> Obesity rate: 28.1% (18th lowest)
> Inactivity rate: 24.4% (19th highest)
> Median household income: $70,305 (15th highest)
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31. Maryland
> Cancer deaths per 100,000: 142.3 (10,799 – 20th highest)
> Smoking rate: 13.8% (8th lowest)
> Obesity rate: 31.0% (23rd highest)
> Inactivity rate: 22.4% (21st lowest)
> Median household income: $87,063 (the highest)
30. Alaska
> Cancer deaths per 100,000: 143.7 (1,043 – 2nd lowest)
> Smoking rate: 21.0% (9th highest)
> Obesity rate: 32.5% (14th highest)
> Inactivity rate: 20.0% (8th lowest)
> Median household income: $77,790 (8th highest)
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29. Nevada
> Cancer deaths per 100,000: 144.1 (5,450 – 17th lowest)
> Smoking rate: 17.6% (19th highest)
> Obesity rate: 25.7% (6th lowest)
> Inactivity rate: 23.1% (24th lowest)
> Median household income: $62,043 (25th lowest)
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28. New Hampshire
> Cancer deaths per 100,000: 145.0 (2,826 – 10th lowest)
> Smoking rate: 15.7% (17th lowest)
> Obesity rate: 27.9% (17th lowest)
> Inactivity rate: 21.3% (14th lowest)
> Median household income: $77,923 (7th highest)
27. Oregon
> Cancer deaths per 100,000: 145.8 (8,283 – 24th lowest)
> Smoking rate: 16.1% (21st lowest)
> Obesity rate: 28.8% (19th lowest)
> Inactivity rate: 17.2% (3rd lowest)
> Median household income: $65,667 (18th highest)
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26. Virginia
> Cancer deaths per 100,000: 146.6 (15,499 – 12th highest)
> Smoking rate: 16.4% (23rd lowest)
> Obesity rate: 29.8% (23rd lowest)
> Inactivity rate: 22.9% (22nd lowest)
> Median household income: $76,398 (10th highest)
24. Georgia
> Cancer deaths per 100,000: 147.6 (17,827 – 10th highest)
> Smoking rate: 17.5% (21st highest)
> Obesity rate: 32.0% (19th highest)
> Inactivity rate: 27.5% (9th highest)
> Median household income: $61,224 (22nd lowest)
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24. Nebraska
> Cancer deaths per 100,000: 147.6 (3,541 – 14th lowest)
> Smoking rate: 15.4% (14th lowest)
> Obesity rate: 32.2% (16th highest)
> Inactivity rate: 23.3% (25th lowest)
> Median household income: $63,015 (25th highest)
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23. Iowa
> Cancer deaths per 100,000: 147.8 (6,304 – 19th lowest)
> Smoking rate: 17.1% (25th lowest)
> Obesity rate: 33.2% (10th highest)
> Inactivity rate: 23.7% (24th highest)
> Median household income: $61,836 (24th lowest)
22. South Dakota
> Cancer deaths per 100,000: 148.1 (1,730 – 5th lowest)
> Smoking rate: 19.3% (14th highest)
> Obesity rate: 31.8% (20th highest)
> Inactivity rate: 21.3% (16th lowest)
> Median household income: $59,896 (20th lowest)
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21. North Carolina
> Cancer deaths per 100,000: 148.4 (19,996 – 9th highest)
> Smoking rate: 17.2% (24th highest)
> Obesity rate: 31.4% (21st highest)
> Inactivity rate: 24.3% (21st highest)
> Median household income: $56,642 (12th lowest)
20. Wisconsin
> Cancer deaths per 100,000: 148.7 (11,654 – 19th highest)
> Smoking rate: 16.0% (20th lowest)
> Obesity rate: 31.3% (22nd highest)
> Inactivity rate: 20.8% (12th lowest)
> Median household income: $63,293 (24th highest)
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19. Illinois
> Cancer deaths per 100,000: 150.9 (24,015 – 7th highest)
> Smoking rate: 15.5% (15th lowest)
> Obesity rate: 29.7% (22nd lowest)
> Inactivity rate: 22.3% (20th lowest)
> Median household income: $68,428 (17th highest)
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18. Delaware
> Cancer deaths per 100,000: 151.1 (2,141 – 8th lowest)
> Smoking rate: 17.0% (24th lowest)
> Obesity rate: 30.9% (24th highest)
> Inactivity rate: 27.7% (8th highest)
> Median household income: $69,110 (16th highest)
17. Kansas
> Cancer deaths per 100,000: 151.4 (5,538 – 18th lowest)
> Smoking rate: 17.4% (22nd highest)
> Obesity rate: 33.2% (11th highest)
> Inactivity rate: 24.8% (17th highest)
> Median household income: $61,091 (21st lowest)
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16. Vermont
> Cancer deaths per 100,000: 152.2 (1,400 – 4th lowest)
> Smoking rate: 15.8% (19th lowest)
> Obesity rate: 26.3% (10th lowest)
> Inactivity rate: 19.1% (6th lowest)
> Median household income: $63,477 (23rd highest)
15. Pennsylvania
> Cancer deaths per 100,000: 153.2 (27,955 – 5th highest)
> Smoking rate: 18.7% (16th highest)
> Obesity rate: 30.3% (25th highest)
> Inactivity rate: 23.1% (23rd lowest)
> Median household income: $63,627 (22nd highest)
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14. South Carolina
> Cancer deaths per 100,000: 153.9 (10,786 – 21st highest)
> Smoking rate: 18.8% (15th highest)
> Obesity rate: 32.9% (12th highest)
> Inactivity rate: 25.9% (14th highest)
> Median household income: $54,864 (10th lowest)
13. Michigan
> Cancer deaths per 100,000: 157.3 (21,158 – 8th highest)
> Smoking rate: 19.3% (13th highest)
> Obesity rate: 32.0% (18th highest)
> Inactivity rate: 23.4% (25th highest)
> Median household income: $59,234 (18th lowest)
12. Missouri
> Cancer deaths per 100,000: 157.9 (12,907 – 15th highest)
> Smoking rate: 20.8% (11th highest)
> Obesity rate: 32.2% (17th highest)
> Inactivity rate: 25.8% (16th highest)
> Median household income: $57,290 (13th lowest)
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11. Ohio
> Cancer deaths per 100,000: 159.1 (24,863 – 6th highest)
> Smoking rate: 21.1% (8th highest)
> Obesity rate: 32.3% (15th highest)
> Inactivity rate: 26.4% (12th highest)
> Median household income: $58,116 (15th lowest)
10. Louisiana
> Cancer deaths per 100,000: 159.9 (9,195 – 25th highest)
> Smoking rate: 23.1% (3rd highest)
> Obesity rate: 35.4% (4th highest)
> Inactivity rate: 29.2% (5th highest)
> Median household income: $50,800 (4th lowest)
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9. Maine
> Cancer deaths per 100,000: 161.5 (3,432 – 12th lowest)
> Smoking rate: 17.3% (23rd highest)
> Obesity rate: 29.9% (24th lowest)
> Inactivity rate: 21.6% (17th lowest)
> Median household income: $59,489 (19th lowest)
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8. Alabama
> Cancer deaths per 100,000: 161.6 (10,456 – 22nd highest)
> Smoking rate: 20.9% (10th highest)
> Obesity rate: 35.5% (3rd highest)
> Inactivity rate: 29.8% (3rd highest)
> Median household income: $52,035 (6th lowest)
7. Indiana
> Cancer deaths per 100,000: 162.7 (13,664 – 14th highest)
> Smoking rate: 21.8% (7th highest)
> Obesity rate: 33.4% (8th highest)
> Inactivity rate: 26.7% (11th highest)
> Median household income: $58,235 (16th lowest)
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6. Arkansas
> Cancer deaths per 100,000: 163.8 (6,496 – 20th lowest)
> Smoking rate: 22.3% (5th highest)
> Obesity rate: 34.2% (5th highest)
> Inactivity rate: 31.6% (2nd highest)
> Median household income: $49,475 (3rd lowest)
5. Tennessee
> Cancer deaths per 100,000: 164.4 (14,436 – 13th highest)
> Smoking rate: 22.6% (4th highest)
> Obesity rate: 33.2% (9th highest)
> Inactivity rate: 27.2% (10th highest)
> Median household income: $54,833 (9th lowest)
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4. Oklahoma
> Cancer deaths per 100,000: 171.1 (8,368 – 25th lowest)
> Smoking rate: 20.1% (12th highest)
> Obesity rate: 33.7% (7th highest)
> Inactivity rate: 29.3% (4th highest)
> Median household income: $53,840 (8th lowest)
3. Mississippi
> Cancer deaths per 100,000: 176.0 (6,582 – 21st lowest)
> Smoking rate: 22.2% (6th highest)
> Obesity rate: 36.8% (the highest)
> Inactivity rate: 31.9% (the highest)
> Median household income: $46,511 (the lowest)
2. West Virginia
> Cancer deaths per 100,000: 177.0 (4,725 – 16th lowest)
> Smoking rate: 26.0% (the highest)
> Obesity rate: 36.7% (2nd highest)
> Inactivity rate: 28.9% (6th highest)
> Median household income: $48,037 (2nd lowest)
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1. Kentucky
> Cancer deaths per 100,000: 177.3 (10,181 – 23rd highest)
> Smoking rate: 24.6% (2nd highest)
> Obesity rate: 33.8% (6th highest)
> Inactivity rate: 28.6% (7th highest)
> Median household income: $52,238 (7th lowest)
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