The States Where the Most People Get Diagnosed With Lung Cancer

The American Lung Association estimates 234,000 Americans will be diagnosed with lung cancer in 2018. Meanwhile, one in four of all cancer deaths will be attributed to this form of the disease. That makes lung cancer the deadliest type of cancer in the U.S.

Yet not everyone faces the same level of risk: Statistics show a huge swing in diagnoses from state to state. For example, you’ll find 29 new cases of lung cancer for every 100,000 people in Utah — the lowest rate in the country.

Meanwhile, in the state with the most diagnoses, statistics show more than three times that amount (97 cases) per 100,000 people. Everything from the amount of toxins in the air to cigarette smoking contributes to these numbers, and both come in abundance in the No. 1 place. Here are the 15 states with the most lung cancer diagnoses every year.

15. Rhode Island

Harbor View of Providence Rhode Island

Rhode Island’s rate of new lung cancer diagnoses is 10% higher than average. | SeanPavonePhoto/iStock/Getty Images

  • While the rate of diagnosis is high, Rhode Islanders have a higher rate of survival.

With 70 cases per 100,000 people, the Rhode Island population’s rate of new lung cancer diagnoses is more than 10% higher than the average. American Lung Association shows state officials are doing a good job here with strong tobacco control policies.

Meanwhile, Rhode Island ranked fifth in America with a 22.4% five-year survival rate for patients.

Next: In the heart of Tobacco Country, this state is failing on reducing smoking in the population.

14. North Carolina

Winston-Salem, NC, USA

There were 71 new lung cancer diagnoses for every 100,000 people in North Carolina. | Bryan Pollard/iStock/Getty Images

  • It’s no surprise finding the home of Tobacco Road on this list.

In a state where the most prestigious university (Duke) was built on tobacco money, it’s no surprise finding North Carolina on the list. The Tar Heel State had 71 new diagnoses of lung cancer per 100,000 people.

By American Lung Association standards, the state’s tobacco control policy received an “F” grade for 2018. Five-year survival rates are about average.

Next: A high smoking rate and low number of screening centers likely landed Ohio in 12th place.

13. Ohio


Ohio has a high rate of smokers. | TraceRouda/iStock/Getty Images

  • In Ohio, the smoking rate is 30% above the national average.

You’ll find a higher-than-average smoking rate (21.6%) and low number of cancer screening centers in Ohio. Both factors likely contributed to the state’s place on this list.

Overall, Ohio gets 71.1 new lung cancer diagnoses per 100,000 people.

Next: High smoking rates helped put Oklahoma on this list, too.

12. Oklahoma

Oklahoma city

There are few cancer-screening centers in Oklahoma. | Saul Loeb/AFP/Getty Images

  • Over 22% of Oklahoma adults are smokers.

Much like the statistics showed in Ohio, a high rate of smokers and a very low number of cancer-screening centers ensured Oklahoma’s place on this list. At 71.6 diagnoses per 100,000 people, the state is among the worst in America.

Since Oklahoma does not track this metric, five-year survival rates for lung cancer patients were unavailable.

Next: You’ll find one of the lowest five-year survival rates for lung cancer patients here.

11. Alabama

Gulf Shores, Alabama

The lung cancer survival rate in Alabama is one of the lowest in the U.S. | nick1803/iStock/Getty Images

  • Only one state had a lower survival rate than Alabama.

At 71.7 new diagnoses per 100,000 people, Alabama’s lung cancer rate nearly made the 10 worst. As far as five-year survival rates go, Alabama had the second-worst percentage (16.3%) among states where data was available.

Like many other places on this list, Alabama’s higher-than-average smoking rate contributed to the numbers.

Next: This Mid-Atlantic state stands out on the list.

10. Delaware

Capitol building in Dover in Delaware

Delaware has a normal rate of smoking but still has a high lung cancer rate . | prosiaczeq/iStock/Getty Images

  • In Delaware, normal smoking rates and abundant screening centers did not help.

No place in America has more lung cancer screening centers per person (21.1) than Delaware. Meanwhile, the state had a normal smoking rate and generally low radon levels.

Nonetheless, it ended up at No. 10 with 71.8 diagnoses per 100,000 people.

Next: This state has the lowest five-year survival rate for lung cancer patients.

9. Louisiana

New Orleans, Louisiana, Bourbon Street

Fewer than 16% of lung cancer patients in Louisiana live more than five years beyond diagnosis. | Robyn Beck/AFP/Getty Images

  • Fewer than 16% of Louisiana lung cancer patients lived five years beyond diagnosis.

In terms of five-year survival rate, Louisiana is the worst state among the 31 where data was available. Just 15.9% of those diagnosed here survived beyond that span.

Overall, Louisiana was eighth with 71.8 lung cancer diagnoses per 100,000 people.

Next: Poor air quality had on impact on the numbers in Indiana.

8. Indiana

Downtown Indianapolis skyline at twilight

Indiana is a highly polluted area with high smoking rates. | iStock/Getty Images

  • Higher-than-average smoking rates and poor air quality lead to more lung cancer diagnoses here.

If you check the annual reports on air quality, you’ll find several Indianapolis cities on the list. In 2018, both the Indianapolis and South Bend metro areas turned up among the most polluted places in America.

Those stats, along with a high smoking rate, help account for the 74.5 new lung cancer diagnoses per 100,000 people in the state.

Next: No numbers jump out at you in Maine, other than diagnosis rates.

7. Maine

Camden, Maine harbor with bright fall foliage in autumn

Maine has a higher-tha-average smoking rate. | EJJohnsonPhotography/iStock/Getty Images

  • Above-average smoking rates likely account for Maine’s place on the list.

At 75 new lung cancer diagnoses per 100,000 people, Maine ranks seventh among the worst for this form of the disease. Outside of the higher-than-average smoking rate, no numbers stick out in the American Lung Association data on the state.

Five-year survival rates and the number of screening centers are around the average in Maine.

Next: This state has more than 20% the average rate of lung cancer diagnoses.

6. Missouri

St. Louis

Above-average smoking rates contribute to Missouri’s higher-than-average lung cancer rate. | Karen Bleier/AFP/Getty Images

  • In Missouri, you find 76.2 diagnoses per 100,000 people, far higher than the national average.

With 20% more new lung cancer cases than the average, Missouri qualifies as a high-risk environment. Above-average smoking rates and high radon levels in buildings contribute to these numbers.

In terms of screening centers, Missouri ranked around the national average.

Next: Only a few states have more smokers than Mississippi. 

5. Mississippi


People in Mississippi like to light up, which contributes to the high number of lung cancer cases. | Sean Pavone/iStock/Getty Images

  • The high smoking rate does the most damage.

With smoking the leading cause of lung cancer in America, it’s no mystery why states with the highest rates of tobacco use also have the most lung cancer patients per capita. In Mississippi’s case, the number every year hits 76.8 cases per 100,000 people.

The state’s five-year survival rate (16.8%) also ranked among America’s worst.

Next: Poor air quality and a lot of smoking put Tennessee in the top four.

4. Tennessee

Memphis Skyline

Memphis and other Tennessess cities have poor air quality. | iStock/Getty Images

  • Smoking rates in Tennessee were 30% above the national average.

You find many more smokers than the national average in Tennessee. Combined with the dangerous air quality in Memphis and other cities, that adds up to a higher likelihood for a lung cancer diagnosis.

For every 100,000 people, Tennessee has 77.2 new lung cancer cases every year.

Next: Smoking rates in Arkansas are about 50% higher than the national average.

3. Arkansas

Little Rock, AR, USA

Smoking is mostly to blame for high lung cancer rates in Arkansas. | csfotoimages/iStock/Getty Images

  • You can blame smoking for most new lung cancer cases in Arkansas.

Only two U.S. state had higher smoking rates than you’ll find in Arkansas (24.9%). That alone would explain the high rate of new lung cancer diagnoses (77.5 per 100,000 people).

However, air quality in Arkansas is also poor, which likely contributed to these numbers.

Next: Coal Country claims the two highest rates of new lung cancer diagnoses.

2. West Virginia

charleston, west virginia

Coal Country has some serious lung cancer issues. | Joe Raedle/Getty Images

  • The 25.7% smoking rate proves lethal in Coal Country, but poor air quality also was a factor.

More than one in four adult West Virginians smokes. Meanwhile, the remaining coal jobs and high levels of toxins in the air spell exposure to poor air quality for state residents.

It all adds up to 81.6 new cases of lung cancer per 100,000 people, about 30% above the national average.

Next: The numbers in Kentucky are way beyond anywhere else in America.

1. Kentucky

Smoking cigrette

Kentucky has the highest smoking rate in America. | Joe Raedle/Getty Images

  • Combine America’s highest smoking rate and toxic air quality and you get Kentucky lung cancer rates.

With 96.8 new lung cancer diagnoses per 100,000 people, the annual numbers in Kentucky go way above and beyond what exists anywhere else in America. Louisville, the state’s most populous city, has some of the worst air quality in the country.

Meanwhile, the 26% smoking rate and prevalence of back lung among coal workers adds up to a public health crisis. Compared to Utah, where new lung cancer rates are lowest, Kentucky has more than three times the number of diagnoses every year.

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