With a combination of early detection, innovative treatments, and a deep reduction in smоking rates, cancer deaths in the U.S. have declined precipitously in the past 20 years. Between 2001 and 2020, the Centers for Disease Control and Prevention reports, the mortality rate from various forms of the disease dropped 27%, from 196.5 to 144.1 deaths per 100,000 population. Unfortunately, even with this significant decline, cancer was the second most common cause of death in the U.S. in 2020, trailing only heart disease.
Compared to where the country was not too long ago, however, the reduction in cancer deaths is remarkable. According to the American Cancer Society, mortality from cancer peaked in 1991, when 215 out of every 100,000 people died from cancer. The organization attributed the rise in cancer deaths from what it called an epidemic of smоking in the 20th century. As more people broke the cigаrette habit, cancer-related illnesses fell. (These are the states where the most people are still getting cancer.)
CDC statistics show that anti-smоking campaigns have worked. In 2005, 20.9% or nearly 21 out of every 100 adults age 18 or older smоked. By 2020, the percentage had shrunk to 12.5%, or 13 of every 100 adults. (Smоkers were defined as those who lit up 100 cigаrettes during their lives and who reported smоking every day or some days at the time they were surveyed.)
Every state has seen a decline – though the change in cancer mortality rates varies by state, with some doing a better job statistically of fighting the deadly disease. Here are the states with the highest smоking rates.
To find the states fighting cancers most successfully, 24/7 Tempo reviewed cancer death data from the Centers for Disease Control and Prevention. States were ranked by the percent change in the cancer death rate – the number of cancer deaths per 100,000 age-adjusted population – from 2000 to 2020. smоking rate changes also came from the CDC. Median household income figures are five-year estimates for 2020 from the Census Bureau American Community Survey.
Click here to see the states fighting cancer most successfully since 2000
New Jersey recorded the highest drop at -35%, followed by Massachusetts at -34.5%. What explains those states’ victories against cancer? Both states have high median household incomes, so perhaps higher incomes allow people better access to healthcare and therefore earlier intervention and treatments for cancer.
50. Oklahoma
> Pct. change in cancer death rate: -17.3%
> Cancer deaths, 2000: 7,402, or 206.8 per 100,000 – 17th highest
> Cancer deaths, 2020: 8,368, or 171.1 per 100,000 – 4th highest
> Smoking rate change: -4.4 ppt (from 23.3% in 2000 to 18.9% in 2019)
> Median household income: $53,840 – 8th lowest
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49. Kansas
> Pct. change in cancer death rate: -18.6%
> Cancer deaths, 2000: 5,223, or 186.1 per 100,000 – 11th lowest
> Cancer deaths, 2020: 5,538, or 151.4 per 100,000 – 17th highest
> Smoking rate change: -4.9 ppt (from 21.1% in 2000 to 16.2% in 2019)
> Median household income: $61,091 – 21st lowest
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48. Hawaii
> Pct. change in cancer death rate: -20.2%
> Cancer deaths, 2000: 1,943, or 155.1 per 100,000 – 2nd lowest
> Cancer deaths, 2020: 2,519, or 123.8 per 100,000 – 2nd lowest
> Smoking rate change: -7.4 ppt (from 19.7% in 2000 to 12.3% in 2019)
> Median household income: $83,173 – 4th highest
47. Nebraska
> Pct. change in cancer death rate: -20.3%
> Cancer deaths, 2000: 3,382, or 185.3 per 100,000 – 10th lowest
> Cancer deaths, 2020: 3,541, or 147.6 per 100,000 – 24th highest
> Smoking rate change: -6.7 ppt (from 21.4% in 2000 to 14.7% in 2019)
> Median household income: $63,015 – 25th highest
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46. Utah
> Pct. change in cancer death rate: -20.5%
> Cancer deaths, 2000: 2,358, or 150.3 per 100,000 – the lowest
> Cancer deaths, 2020: 3,460, or 119.5 per 100,000 – the lowest
> Smoking rate change: -5 ppt (from 12.9% in 2000 to 7.9% in 2019)
> Median household income: $74,197 – 12th highest
45. West Virginia
> Pct. change in cancer death rate: -20.5%
> Cancer deaths, 2000: 4,753, or 222.7 per 100,000 – 3rd highest
> Cancer deaths, 2020: 4,725, or 177 per 100,000 – 2nd highest
> Smoking rate change: -2.3 ppt (from 26.1% in 2000 to 23.8% in 2019)
> Median household income: $48,037 – 2nd lowest
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44. Mississippi
> Pct. change in cancer death rate: -21%
> Cancer deaths, 2000: 6,075, or 222.7 per 100,000 – 3rd highest
> Cancer deaths, 2020: 6,582, or 176 per 100,000 – 3rd highest
> Smoking rate change: -3.1 ppt (from 23.5% in 2000 to 20.4% in 2019)
> Median household income: $46,511 – the lowest
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43. South Dakota
> Pct. change in cancer death rate: -21.8%
> Cancer deaths, 2000: 1,597, or 189.4 per 100,000 – 13th lowest
> Cancer deaths, 2020: 1,730, or 148.1 per 100,000 – 22nd highest
> Smoking rate change: -3.7 ppt (from 22% in 2000 to 18.3% in 2019)
> Median household income: $59,896 – 20th lowest
42. Arkansas
> Pct. change in cancer death rate: -21.9%
> Cancer deaths, 2000: 6,090, or 209.6 per 100,000 – 13th highest
> Cancer deaths, 2020: 6,496, or 163.8 per 100,000 – 6th highest
> Smoking rate change: -5 ppt (from 25.2% in 2000 to 20.2% in 2019)
> Median household income: $49,475 – 3rd lowest
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41. Wisconsin
> Pct. change in cancer death rate: -22%
> Cancer deaths, 2000: 10,638, or 190.7 per 100,000 – 16th lowest
> Cancer deaths, 2020: 11,654, or 148.7 per 100,000 – 20th highest
> Smoking rate change: -8.7 ppt (from 24.1% in 2000 to 15.4% in 2019)
> Median household income: $63,293 – 24th highest
> Pct. change in cancer death rate: -22%
> Cancer deaths, 2000: 10,638, or 190.7 per 100,000 – 16th lowest
> Cancer deaths, 2020: 11,654, or 148.7 per 100,000 – 20th highest
> Smoking rate change: -8.7 ppt (from 24.1% in 2000 to 15.4% in 2019)
> Median household income: $63,293 – 24th highest
40. Kentucky
> Pct. change in cancer death rate: -22.2%
> Cancer deaths, 2000: 9,207, or 227.9 per 100,000 – the highest
> Cancer deaths, 2020: 10,181, or 177.3 per 100,000 – the highest
> Smoking rate change: -6.9 ppt (from 30.5% in 2000 to 23.6% in 2019)
> Median household income: $52,238 – 7th lowest
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39. Iowa
> Pct. change in cancer death rate: -22.5%
> Cancer deaths, 2000: 6,448, or 190.6 per 100,000 – 15th lowest
> Cancer deaths, 2020: 6,304, or 147.8 per 100,000 – 23rd highest
> Smoking rate change: -6.9 ppt (from 23.3% in 2000 to 16.4% in 2019)
> Median household income: $61,836 – 24th lowest
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38. Michigan
> Pct. change in cancer death rate: -22.6%
> Cancer deaths, 2000: 19,798, or 203.2 per 100,000 – 25th lowest
> Cancer deaths, 2020: 21,158, or 157.3 per 100,000 – 13th highest
> Smoking rate change: -5.5 ppt (from 24.2% in 2000 to 18.7% in 2019)
> Median household income: $59,234 – 18th lowest
37. Vermont
> Pct. change in cancer death rate: -22.9%
> Cancer deaths, 2000: 1,240, or 197.5 per 100,000 – 23rd lowest
> Cancer deaths, 2020: 1,400, or 152.2 per 100,000 – 16th highest
> Smoking rate change: -6.4 ppt (from 21.5% in 2000 to 15.1% in 2019)
> Median household income: $63,477 – 23rd highest
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36. Missouri
> Pct. change in cancer death rate: -23%
> Cancer deaths, 2000: 12,144, or 205.1 per 100,000 – 23rd highest
> Cancer deaths, 2020: 12,907, or 157.9 per 100,000 – 12th highest
> Smoking rate change: -7.6 ppt (from 27.2% in 2000 to 19.6% in 2019)
> Median household income: $57,290 – 13th lowest
35. North Dakota
> Pct. change in cancer death rate: -23.4%
> Cancer deaths, 2000: 1,346, or 182 per 100,000 – 8th lowest
> Cancer deaths, 2020: 1,308, or 139.5 per 100,000 – 16th lowest
> Smoking rate change: -6.3 ppt (from 23.3% in 2000 to 17% in 2019)
> Median household income: $65,315 – 19th highest
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34. Idaho
> Pct. change in cancer death rate: -24%
> Cancer deaths, 2000: 2,128, or 179.5 per 100,000 – 6th lowest
> Cancer deaths, 2020: 3,004, or 136.5 per 100,000 – 13th lowest
> Smoking rate change: -7.1 ppt (from 22.4% in 2000 to 15.3% in 2019)
> Median household income: $58,915 – 17th lowest
33. Indiana
> Pct. change in cancer death rate: -24%
> Cancer deaths, 2000: 12,842, or 214 per 100,000 – 7th highest
> Cancer deaths, 2020: 13,664, or 162.7 per 100,000 – 7th highest
> Smoking rate change: -7.8 ppt (from 27% in 2000 to 19.2% in 2019)
> Median household income: $58,235 – 16th lowest
32. Maine
> Pct. change in cancer death rate: -24.1%
> Cancer deaths, 2000: 3,070, or 212.8 per 100,000 – 8th highest
> Cancer deaths, 2020: 3,432, or 161.5 per 100,000 – 9th highest
> Smoking rate change: -6.2 ppt (from 23.8% in 2000 to 17.6% in 2019)
> Median household income: $59,489 – 19th lowest
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31. New Mexico
> Pct. change in cancer death rate: -24.5%
> Cancer deaths, 2000: 2,905, or 171.9 per 100,000 – 4th lowest
> Cancer deaths, 2020: 3,649, or 129.8 per 100,000 – 6th lowest
> Smoking rate change: -7.6 ppt (from 23.6% in 2000 to 16% in 2019)
> Median household income: $51,243 – 5th lowest
30. Tennessee
> Pct. change in cancer death rate: -24.6%
> Cancer deaths, 2000: 12,339, or 218 per 100,000 – 5th highest
> Cancer deaths, 2020: 14,436, or 164.4 per 100,000 – 5th highest
> Smoking rate change: -5.8 ppt (from 25.7% in 2000 to 19.9% in 2019)
> Median household income: $54,833 – 9th lowest
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29. Ohio
> Pct. change in cancer death rate: -24.6%
> Cancer deaths, 2000: 24,988, or 211 per 100,000 – 12th highest
> Cancer deaths, 2020: 24,863, or 159.1 per 100,000 – 11th highest
> Smoking rate change: -5.5 ppt (from 26.3% in 2000 to 20.8% in 2019)
> Median household income: $58,116 – 15th lowest
28. Alabama
> Pct. change in cancer death rate: -24.7%
> Cancer deaths, 2000: 9,807, or 214.7 per 100,000 – 6th highest
> Cancer deaths, 2020: 10,456, or 161.6 per 100,000 – 8th highest
> Smoking rate change: -5.1 ppt (from 25.3% in 2000 to 20.2% in 2019)
> Median household income: $52,035 – 6th lowest
27. Colorado
> Pct. change in cancer death rate: -24.9%
> Cancer deaths, 2000: 5,922, or 169.4 per 100,000 – 3rd lowest
> Cancer deaths, 2020: 8,252, or 127.2 per 100,000 – 3rd lowest
> Smoking rate change: -6.6 ppt (from 20.1% in 2000 to 13.5% in 2019)
> Median household income: $75,231 – 11th highest
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26. Delaware
> Pct. change in cancer death rate: -25.3%
> Cancer deaths, 2000: 1,609, or 202.2 per 100,000 – 24th lowest
> Cancer deaths, 2020: 2,141, or 151.1 per 100,000 – 18th highest
> Smoking rate change: -7.1 ppt (from 23% in 2000 to 15.9% in 2019)
> Median household income: $69,110 – 16th highest
25. Pennsylvania
> Pct. change in cancer death rate: -25.6%
> Cancer deaths, 2000: 30,160, or 206 per 100,000 – 20th highest
> Cancer deaths, 2020: 27,955, or 153.2 per 100,000 – 15th highest
> Smoking rate change: -7 ppt (from 24.3% in 2000 to 17.3% in 2019)
> Median household income: $63,627 – 22nd highest
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24. Oregon
> Pct. change in cancer death rate: -25.8%
> Cancer deaths, 2000: 6,951, or 196.5 per 100,000 – 22nd lowest
> Cancer deaths, 2020: 8,283, or 145.8 per 100,000 – 24th lowest
> Smoking rate change: -6.3 ppt (from 20.8% in 2000 to 14.5% in 2019)
> Median household income: $65,667 – 18th highest
23. Wyoming
> Pct. change in cancer death rate: -26.3%
> Cancer deaths, 2000: 868, or 184.9 per 100,000 – 9th lowest
> Cancer deaths, 2020: 1,029, or 136.3 per 100,000 – 12th lowest
> Smoking rate change: -5.4 ppt (from 23.8% in 2000 to 18.4% in 2019)
> Median household income: $65,304 – 20th highest
22. Montana
> Pct. change in cancer death rate: -26.7%
> Cancer deaths, 2000: 1,867, or 193.1 per 100,000 – 19th lowest
> Cancer deaths, 2020: 2,138, or 141.5 per 100,000 – 18th lowest
> Smoking rate change: -2.3 ppt (from 18.9% in 2000 to 16.6% in 2019)
> Median household income: $56,539 – 11th lowest
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21. North Carolina
> Pct. change in cancer death rate: -27%
> Cancer deaths, 2000: 15,785, or 203.4 per 100,000 – 25th highest
> Cancer deaths, 2020: 19,996, or 148.4 per 100,000 – 21st highest
> Smoking rate change: -7.6 ppt (from 26.1% in 2000 to 18.5% in 2019)
> Median household income: $56,642 – 12th lowest
20. Minnesota
> Pct. change in cancer death rate: -27.3%
> Cancer deaths, 2000: 9,215, or 190.9 per 100,000 – 17th lowest
> Cancer deaths, 2020: 9,944, or 138.7 per 100,000 – 15th lowest
> Smoking rate change: -5.2 ppt (from 19.8% in 2000 to 14.6% in 2019)
> Median household income: $73,382 – 13th highest
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19. South Carolina
> Pct. change in cancer death rate: -27.4%
> Cancer deaths, 2000: 8,250, or 212 per 100,000 – 9th highest
> Cancer deaths, 2020: 10,786, or 153.9 per 100,000 – 14th highest
> Smoking rate change: -7.2 ppt (from 24.7% in 2000 to 17.5% in 2019)
> Median household income: $54,864 – 10th lowest
18. Arizona
> Pct. change in cancer death rate: -27.7%
> Cancer deaths, 2000: 9,073, or 176.6 per 100,000 – 5th lowest
> Cancer deaths, 2020: 12,676, or 127.7 per 100,000 – 4th lowest
> Smoking rate change: -3.7 ppt (from 18.6% in 2000 to 14.9% in 2019)
> Median household income: $61,529 – 23rd lowest
17. California
> Pct. change in cancer death rate: -28.2%
> Cancer deaths, 2000: 53,155, or 181.5 per 100,000 – 7th lowest
> Cancer deaths, 2020: 59,778, or 130.3 per 100,000 – 7th lowest
> Smoking rate change: -7.2 ppt (from 17.2% in 2000 to 10% in 2019)
> Median household income: $78,672 – 6th highest
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16. Florida
> Pct. change in cancer death rate: -28.3%
> Cancer deaths, 2000: 39,183, or 190 per 100,000 – 14th lowest
> Cancer deaths, 2020: 45,800, or 136.3 per 100,000 – 12th lowest
> Smoking rate change: -8.4 ppt (from 23.2% in 2000 to 14.8% in 2019)
> Median household income: $57,703 – 14th lowest
15. Georgia
> Pct. change in cancer death rate: -28.4%
> Cancer deaths, 2000: 13,690, or 206.1 per 100,000 – 19th highest
> Cancer deaths, 2020: 17,827, or 147.6 per 100,000 – 24th highest
> Smoking rate change: -7.3 ppt (from 23.6% in 2000 to 16.3% in 2019)
> Median household income: $61,224 – 22nd lowest
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14. Texas
> Pct. change in cancer death rate: -28.6%
> Cancer deaths, 2000: 33,300, or 195.7 per 100,000 – 21st lowest
> Cancer deaths, 2020: 42,142, or 139.8 per 100,000 – 17th lowest
> Smoking rate change: -7.3 ppt (from 22% in 2000 to 14.7% in 2019)
> Median household income: $63,826 – 21st highest
13. Illinois
> Pct. change in cancer death rate: -28.6%
> Cancer deaths, 2000: 25,365, or 211.4 per 100,000 – 11th highest
> Cancer deaths, 2020: 24,015, or 150.9 per 100,000 – 19th highest
> Smoking rate change: -7.8 ppt (from 22.3% in 2000 to 14.5% in 2019)
> Median household income: $68,428 – 17th highest
12. Washington
> Pct. change in cancer death rate: -29%
> Cancer deaths, 2000: 10,668, or 195.3 per 100,000 – 20th lowest
> Cancer deaths, 2020: 12,796, or 138.7 per 100,000 – 15th lowest
> Smoking rate change: -8.1 ppt (from 20.7% in 2000 to 12.6% in 2019)
> Median household income: $77,006 – 9th highest
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11. Connecticut
> Pct. change in cancer death rate: -29.1%
> Cancer deaths, 2000: 7,065, or 188.6 per 100,000 – 12th lowest
> Cancer deaths, 2020: 6,638, or 133.8 per 100,000 – 9th lowest
> Smoking rate change: -7.9 ppt (from 20% in 2000 to 12.1% in 2019)
> Median household income: $79,855 – 5th highest
10. Virginia
> Pct. change in cancer death rate: -29.5%
> Cancer deaths, 2000: 13,528, or 207.9 per 100,000 – 16th highest
> Cancer deaths, 2020: 15,499, or 146.6 per 100,000 – 25th lowest
> Smoking rate change: -7.5 ppt (from 21.5% in 2000 to 14% in 2019)
> Median household income: $76,398 – 10th highest
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9. New Hampshire
> Pct. change in cancer death rate: -29.6%
> Cancer deaths, 2000: 2,484, or 206 per 100,000 – 20th highest
> Cancer deaths, 2020: 2,826, or 145 per 100,000 – 23rd lowest
> Smoking rate change: -9.5 ppt (from 25.4% in 2000 to 15.9% in 2019)
> Median household income: $77,923 – 7th highest
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8. Louisiana
> Pct. change in cancer death rate: -29.7%
> Cancer deaths, 2000: 9,400, or 227.3 per 100,000 – 2nd highest
> Cancer deaths, 2020: 9,195, or 159.9 per 100,000 – 10th highest
> Smoking rate change: -2.2 ppt (from 24.1% in 2000 to 21.9% in 2019)
> Median household income: $50,800 – 4th lowest
7. Rhode Island
> Pct. change in cancer death rate: -31%
> Cancer deaths, 2000: 2,433, or 205.3 per 100,000 – 22nd highest
> Cancer deaths, 2020: 2,076, or 141.6 per 100,000 – 19th lowest
> Smoking rate change: -10.2 ppt (from 23.5% in 2000 to 13.3% in 2019)
> Median household income: $70,305 – 15th highest
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6. Alaska
> Pct. change in cancer death rate: -31.2%
> Cancer deaths, 2000: 704, or 208.8 per 100,000 – 15th highest
> Cancer deaths, 2020: 1,043, or 143.7 per 100,000 – 21st lowest
> Smoking rate change: -7.6 ppt (from 25% in 2000 to 17.4% in 2019)
> Median household income: $77,790 – 8th highest
5. Nevada
> Pct. change in cancer death rate: -31.9%
> Cancer deaths, 2000: 3,762, or 211.6 per 100,000 – 10th highest
> Cancer deaths, 2020: 5,450, or 144.1 per 100,000 – 22nd lowest
> Smoking rate change: -13.4 ppt (from 29.1% in 2000 to 15.7% in 2019)
> Median household income: $62,043 – 25th lowest
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4. Maryland
> Pct. change in cancer death rate: -31.9%
> Cancer deaths, 2000: 10,289, or 209 per 100,000 – 14th highest
> Cancer deaths, 2020: 10,799, or 142.3 per 100,000 – 20th lowest
> Smoking rate change: -7.9 ppt (from 20.6% in 2000 to 12.7% in 2019)
> Median household income: $87,063 – the highest
3. New York
> Pct. change in cancer death rate: -32.7%
> Cancer deaths, 2000: 37,197, or 191.3 per 100,000 – 18th lowest
> Cancer deaths, 2020: 32,955, or 128.8 per 100,000 – 5th lowest
> Smoking rate change: -8.9 ppt (from 21.6% in 2000 to 12.7% in 2019)
> Median household income: $71,117 – 14th highest
2. Massachusetts
> Pct. change in cancer death rate: -34.5%
> Cancer deaths, 2000: 14,027, or 206.3 per 100,000 – 18th highest
> Cancer deaths, 2020: 12,376, or 135.2 per 100,000 – 10th lowest
> Smoking rate change: -8 ppt (from 20% in 2000 to 12% in 2019)
> Median household income: $84,385 – 3rd highest
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1. New Jersey
> Pct. change in cancer death rate: -35%
> Cancer deaths, 2000: 18,072, or 205.1 per 100,000 – 23rd highest
> Cancer deaths, 2020: 15,576, or 133.4 per 100,000 – 8th lowest
> Smoking rate change: -7.9 ppt (from 21% in 2000 to 13.1% in 2018)
> Median household income: $85,245 – 2nd highest
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