— Prostate, breast, and lung cancer are increasing in Iowa faster than in the U.S. overall
October 17, 2026 • 5 min read
Iowa is facing a budget deficit, high costs, and economic strain from trade disputes that have squeezed farmers.
But problems that have simmered for decades -- water quality and cancer rates -- have been forced to the forefront of state politics this year. They are the focus of debate questions, roundtable events, and campaign advertisements for candidates from both parties, up and down the ballot.
The issue has historically been politically taboo to avoid pointing fingers at the powerful agricultural industry in Iowa, one of the country's top producers of corn, soybeans, and hogs. Chemical fertilizers and animal waste contain nitrates and phosphorus that can get washed with rain or snowmeltopens in a new tab or window into the state's web of rivers.
The problem has long caused tensionopens in a new tab or window between Iowa's more liberal urban centers, which rely on rivers and lakes for drinking water, and mostly conservative stewards of its rich farmland. Farmers are increasingly participating in practices to prevent runoff, although critics say the lack of regulation forces downstream Iowans to pay for the pollutionopens in a new tab or window.
The spotlight has grown -- and the political calculus has shifted -- after back-to-back years of restrictions on water useopens in a new tab or window in the Des Moines area coupled with a burgeoning "Make America Healthy Again (MAHA)" movementopens in a new tab or window in Iowa's small towns and rural communitiesopens in a new tab or window.
Cancer Rates Are a Growing Problem in Iowa
Iowa has the second highest rate of newly diagnosed cancers in the country. Specific diagnoses, like prostate, breast, and lung cancer are increasing in Iowa faster than in the U.S. overall. It's affecting urban and rural parts of the state.
New state-funded research at the University of Iowa shows most -- but not all -- of Iowa's above-normal rates for five cancers can be explained by demographic and behavioral factors, such as smoking and binge drinking. Researchers next assess environmental factors, including nitrate levels.
"The real issue is the water and the nitrates," said Democrat Josh Turek, who is running for U.S. Senate, as he talked with cancer patients last week. "Every Iowan deserves when they turn on the tap to ensure that their water is clean and not giving them cancer."
Some studies have found a link between nitrates in drinking water and certain diseases, but it remains an area of debate. The U.S. Environmental Protection Agency does not currently classify nitrates as a cancer risk. The agency initiated a plan to review that assessment in 2017, but it's been stalled, revived, and stalled again under different White House administrations.
The Republican congresswoman running against Turek, Ashley Hinson, recently gathered farmers, researchers, and local officials to discuss Iowa's water problems. She said there is an ongoing need for investments in infrastructure, water quality monitoring, and conservation programs to ensure Iowans have safe drinking water. She also said people can feel safe because treated tap water meets federal regulations.
"We all know that we have some challenges here in Iowa," she said. "I don't think water quality is a partisan issue."
Farm Runoff Is a Key Contributor to River Pollution -- and Political Tensions
It's been more than a decade since the Des Moines area's water utility, fed up with paying roughly $16,000 per day to remove nitrates from water, sued counties further upstream to get them to help cover the cost. The complaint was ultimately dismissed, and Iowa's Republican leaders celebrated the ruling.
Last year, Central Iowa Water Works issued its first-ever ban on lawn watering to reduce demand on its nitrate removal facilities, and state politicians rejected any suggestion of a "blame game" that would implicate farmers. Iowa had been investing nearly $100 million annually in its nutrient reduction strategy in recent years.
In May, though, Republican Gov. Kim Reynolds and lawmakers committed an additional $320 million for water infrastructure, conservation initiative incentives, and other projects, including millions to Central Iowa Water Works to update equipment.
"Water quality isn't a farm issue. It isn't a city issue, and it isn't a political issue," Reynolds said. "But it absolutely is non-negotiable."
Still, criticism of slow progress has continued, including from candidates running to replace Reynolds.
Governor Candidates Make the Issue Central
Republican Zach Lahnopens in a new tab or window and Democrat Rob Sandopens in a new tab or window both emphasize that the state needs to better prioritize the water problem, though neither have called for mandating farming conservation practices that reduce runoff.
Lahn, who was endorsed early in his primaryopens in a new tab or window by political committee MAHA Action, has diverged from many of his Republican peers in directly linking polluted water and agrochemicals to Iowa's cancer crisis.
At Lahn's agriculture-focused town hall in northeast Iowa in August, one attendee raised the issue.
"Right now the farmers, I would say, are really getting blamed for the high cancer rate in Iowa," she said. "Even our daughter calls from Des Moines and says: 'Should we be drinking this water?'"
Lahn said he knows certain agrochemicals are important "tools in the tool chest."
"We're not here to ban products," he said, "but we do have to address the water quality issue."
Federal regulations say drinking water is safe with a maximum nitrate level of 10 mg per liter. That threshold was set to prevent what's known as blue baby syndrome, a condition when an infant's blood doesn't have enough oxygen, but more scientific studies are now analyzing the relationship between nitrate-laden water below that threshold and certain cancers.
Lahn said he tested the nitrate levels from his well water and creek in rural east-central Iowa, finding both well above the federal limit.
Central Iowa Water Works ran its nitrate removal treatment for a record 193 days straight earlier this year, and the treated water's nitrate levels hovered around 8 to 9 mg per liter in the heart of summer.
Sand usually references water early in his stump speech, naming one reason he initially registered as a Democrat is the party's advocacy for clean water because he likes to fish. He said Tuesday after meeting with cancer survivors and parents of children with cancer that he's seen the topic rise in the public consciousness over the past few years.
"I hear from people regularly who are so concerned about it that they wonder whether or not they want to be in Iowa," Sand said.
Iowa's Race for Agriculture Secretary Illustrates the Tension
Twenty years ago, research scientist Chris Jones, PhD, said he'd give his boss at Des Moines' water utility updates on the rivers' nitrate levels.
"He'd say to me, 'Where's the outrage?'" Jones recalled. "Now, the outrage has arrived."
Jones, who later worked on water quality monitors at the University of Iowa, says it's a huge failure of the state for Iowans to lose faith in drinking water.
Jones is a Democrat running in the election to be Iowa's secretary of agriculture, trying to unseat incumbent Republican Mike Naig.
Chief among their differences is whether conservation solutions should be mandatory. In a debate, Naig said Jones is an outlier in demanding farmers be required to adopt conservation practices. Iowa's agricultural industry resists mandates, in part because not all farmers own the land they farm and some conservation efforts might lead to profit loss, at least initially.
Naig, who previously worked for chemical manufacturer Monsanto, highlighted the records that his department has set under Reynolds' leadership and said conservation work is being scaled up to accelerate progress.
"It's been a hot topic on the campaign trail," Naig said, but "we have to have a long view of these things, and we're making progress."