- South Dakota ranks as the highest-risk state for cancer, driven primarily by high rates of excessive alcohol consumption and elevated radon levels.
- Smoking and obesity emerge as critical cancer risk factors, with West Virginia showing the highest smoking rate and obesity rates among all states.
- New Hampshire recorded the highest stress index (47) despite having the lowest obesity and smoking rates among top-ranked states.
A recent study by Masumi identified and ranked U.S. states with the highest combination of risk factors contributing to cancer. Data was collected on cancer new cases and deaths (2024), population (2024), and various cancer risk factors, including smoking rates, obesity rates, radon levels, stress levels, alcohol consumption, the population aged 65 and above, UV radiation index, air pollution, and water hardness. States were ranked in descending order, with higher scores representing greater overall cancer risk.
| State | Alcohol Excessive Consumption Rate | Smoking Rate | Obesity Rate | Radon Level | Stress Level Index | Composite Score |
|---|---|---|---|---|---|---|
| South Dakota | 24.4% | 19.3% | 38.4% | 9.6 | 49 | 99.9 |
| West Virginia | 15.2% | 26.0% | 40.6% | 6.1 | 6 | 98.4 |
| Pennsylvania | 19.8% | 18.7% | 33.3% | 8.6 | 33 | 86.0 |
| Ohio | 20.7% | 21.1% | 37.7% | 7.8 | 17 | 83.4 |
| Kentucky | 18.2% | 24.6% | 40.3% | 7.4 | 8 | 82.6 |
| Maine | 22.5% | 17.3% | 31.9% | 5.9 | 20 | 78.2 |
| Iowa | 24.6% | 17.1% | 36.4% | 6.1 | 46 | 76.9 |
| Montana | 24.3% | 17.2% | 31.8% | 7.4 | 30 | 76.4 |
| Wisconsin | 25.2% | 16.0% | 33.9% | 5.7 | 38 | 68.0 |
| New Hampshire | 20.8% | 15.7% | 30.6% | 5.6 | 47 | 67.9 |
You can view the full research here.
South Dakota leads the ranking with a composite score of 99.9, presenting an alarming concentration of cancer risk factors. The state records the highest radon level (9.6) among all analyzed states, creating significant indoor exposure risks. South Dakota’s excessive alcohol consumption rate of 24.4% contributes substantially to its overall cancer risk profile, while its obesity rate of 38.4% further enhances health concerns. The state also faces challenges with stress levels (49), ranking among the highest in the study.
West Virginia ranks 2nd with a score of 98.4, displaying the highest smoking rate (26%) among the top 10 states. West Virginia also leads with the highest obesity rate (40.6%) and has the largest elderly population (21.5%) among the top-ranked states, creating a particularly vulnerable demographic profile.
Pennsylvania ranks 3rd with a score of 86, balancing multiple risk factors across categories. The state shows concerning levels of radon (8.6) and relatively high stress levels (33). Pennsylvania’s high obesity rate (33.3%) and bad air pollution (6) further compound cancer risks.
Ohio ranks 4th with a score of 83.44, with the highest air pollution (8.9) among the top states. Its smoking rate (21.1%) and obesity rate (37.7%) are also among the highest, and stress levels (17) are noticeably elevated, compounding the state’s cancer risk.
Kentucky ranks fifth with a score of 82.61, showing the second-highest smoking rate (24.6%) and obesity rate (40.3%). Despite having a lower elderly population (17.8%), the state’s lifestyle risk factors put residents at significant cancer risk.
Maine ranks 6th with a score of 78.22, having the highest percentage of population aged 65+ (23%) among all studied states. Maine’s northern location results in the lowest UV radiation index of 6 among the top states, providing some protection against skin cancer risks.
Iowa ranks 7th with a score of 76.91, showing the second-highest excessive alcohol consumption rate (24.6%) among the top states. Iowa combines high obesity rates (36.4%) with high water hardness scores (70), creating multiple pathways for cancer risk.
Montana ranks 8th with a score of 76.42, facing the highest UV radiation exposure (8) among all top 10 states due to its elevation and geographic location. Montana shows the third-highest excessive alcohol consumption rate (24.3%) and records a relatively high water hardness score (70).
Wisconsin ranks 9th with a score of 68.03, recording the highest excessive alcohol consumption rate (25.2%) among all analyzed states, more than New Hampshire’s 20.8%, making Wisconsin more prone to alcohol-related cancers. Wisconsin also shows a high stress level index (38), creating significant psychosocial cancer risk factors.
New Hampshire rounds out the top 10 with a score of 67.94, presenting the highest stress levels (47) in the study. While it has the lowest obesity (30.6%) and smoking rates (15.7%) among the top 10, the state’s high stress and moderate alcohol consumption (20.8%) still make it a high-risk state for cancer.
A spokesperson from Masumi commented on the study: “While the common understanding is that lifestyle choices like smoking and drinking contribute to cancer risk, recent research emphasizes a more nuanced connection between environmental factors and health outcomes. For example, exposure to radon, a silent but potent carcinogen, can significantly alter cancer risk over time, particularly when compounded by other stressors like air pollution. What remains critical is an integrated approach to health, where the effects of multiple risk factors—sometimes subtle, often interrelated—are considered together rather than in isolation.”
