The Hot Spot: Investigating Cancer in Iowa

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Iowa Starting Line

It's Tuesday, August 11, 2026.

Amie here. I'm putting your nitrate test strips in the mail this week, so expect that. (If you get an envelope with your address handwritten on a label and no return address, that's from me!)

 

Inside, you'll find: 

  • a test strip;
  • instructions on how to use the test strip (we're just looking for the nitrate, not nitrite, number); and
  • a QR code where you can upload your results to us.

Submissions for these are closed, unfortunately—we had *way* more folks sign up to get a nitrate test strip than I budgeted for! I'm trying to spread them out to as many cities in Iowa as I can, so we can get a good cross-section of the state for our results. We'll collect those and make them public soon, likely in September.

 

Now, for this week's Cancer in Iowa investigation:

 

When we ask Iowans what they think might have caused their cancer, or the cancer in their loved ones, there's one thing that keeps popping up, especially among farmers.

 

Zachary Oren Smith has the scoop below.

 

If this was forwarded to you, subscribe to the rest of our Cancer in Iowa series here, or share your cancer story here.

Amie Rivers

Newsletter Editor, Iowa Starting Line

Email me
 

How pesticides help fuel Iowa’s cancer crisis

By Zachary Oren Smith 

 

Don Carpenter remembers when farming looked different. Growing up on his family’s 160-acre dairy farm in Cascade, Iowa, he watched his father apply pesticides for about a month each spring: a seasonal ritual that seemed manageable, contained.

 

“It’s what you did,” the 54-year-old Carpenter said. “You didn’t know any better.”

 

The north fork of the Maquoketa River winds through Cascade on its way through Dubuque County. Along its length, acres of farmland stretch on, row by row on either side of the river.

 

"Every time that plane goes over and comes near the river, I just shake my head," he said. "I understand you have to take care of the corn, but it just drives me nuts that they're spraying (pesticides) so close to a body of water."

From family farms to chemical dependence

 

Thirty million acres—nearly three-fourths—of Iowa’s area is used for crops and rotational pastures. While the number of farms in the state has decreased, these operations and their size have grown dramatically over the years. In 1950, the average farm size in Iowa was 169 acres. By 2012, the average farm size had doubled, to 345 acres. 

 

Carpenter said he’s watched these “super farms” buy out family operations like his. 

 

In 2024, Iowa produced 2.5 million bushels of corn for grain production—the most of any state in the country. Farmers apply herbicides to 96% to 97% of corn acres annually. More than 53 million pounds of pesticides are applied across the state each year. 

 

Pesticides encompass a range of chemicals that control any number of unwanted organisms:

  • herbicides, which eliminate or inhibit the growth of unwanted plants;
  • fungicides, which do the same to fungus; and
  • insecticides, which get rid of bugs. 

Pesticides are applied multiple times during the growing season to limit weeds and harmful insects. The corn in the field is genetically engineered to be resistant to particular formulations of pesticides.

 

“Iowa farmers spread more pesticide, fertilizer and manure than any other state,” said Jennifer Breon, an Iowa organizer with Food & Water Watch.

 

Pesticides are part of why Iowa’s fields are so productive. Research into pesticide exposure also connects them to our cancer crisis. 

Science linking certain pesticides to cancer

 

Iowa Starting Line spoke to researchers ranging from oncologists to toxicologists, most of whom pointed to The Agricultural Health Study (AHS) as the highest quality study of agricultural exposure and its impact on health. Since 1993, the study has tracked 89,000 farmers and their spouses across Iowa and North Carolina. In general, participants in the AHS had lower overall cancer incidence, attributed to low rates of smoking and increased physical activity. 

 

However, a 2019 review of two decades of AHS data found agricultural exposures led to a disproportionate rate of prostate cancer among these farming couples.

 

According to the 2025 Iowa Cancer Registry, prostate cancer accounted for 14% of Iowa’s new cancers, almost as common as breast cancer. The AHS also found these couples suffered from elevated rates of lip cancer, certain B-cell lymphomas like multiple myeloma, acute myeloid leukemia (AML), thyroid cancer, testicular cancer, and peritoneal cancer.

 

The most widely used of our herbicides is glyphosate. It’s found in products like Roundup, which was manufactured by Monsanto until Bayer bought the company in 2018. It’s estimated that 16 million pounds of glyphosate-based herbicides are applied in Iowa each year. 

 

In 2015, the International Agency for Research on Cancer (IARC) changed glyphosate’s classification to “probably carcinogenic,” following a review of data surrounding exposure’s link to non-Hodgkin lymphoma (NHL). One analysis that used data from the AHS showed glyphosate-based herbicides were associated with a 41% increase in NHL risk. 

 

Despite the growing evidence of its connection to cancer, the chemical remains in wide use. The US Environmental Protection Agency said it is “unlikely to be a human carcinogen.” The federal agency is currently updating its evaluation of glyphosate’s carcinogenic potential.

 

And that’s part of how the process works: the slow grind of regulators taking in and sometimes adjusting to what research says. 

Minding the regulatory gap

 

Experts point out that regulation doesn’t automatically adjust to the most recent science. It’s not even standard across nations. A 2019 paper found that, of the 1.2 billion pounds of pesticides used in the US in 2016, 322 million pounds were pesticides banned by the European Union; 40 million were pesticides banned in China; 26 million were banned in Brazil. 

 

This evolution in understanding creates what Dr. David Cwiertny, the director of the Center for Health Effects of Environmental Contamination at the University of Iowa, calls a "gray area" where policy still considers something safe while emerging science suggests it may not be. That lag between scientific discovery and policy is time in which vulnerable populations continue to be exposed to something that could be harming them.

 

Cwiertny’s team measures pesticide concentrations in waterways, air, and dust throughout agricultural regions. He said they rarely find a water sample that doesn't contain at least one or two major chemicals, even in remote areas—what Cwiertny calls "ubiquity" that reflects decades of sustained use.

 

Charles Benbrook, an agricultural economist who has advocated against the increased application of chemicals like glyphosate, has called for the EPA to not approve chemicals based on limited exposure scenarios, but based on the widespread, repeated use that is seen across states like Iowa.

 

"The pesticide risk assessment and regulatory decision process as carried out by EPA and its sister regulators in the state... is basically broken,” Benbrook said. 

 

He was most recently in Iowa advocating against a bill that would restrict the ability of individuals to sue pesticide manufacturers like Bayer for health issues, such as cancer, that could be linked to the companies’ products. 

 

An analysis by Food & Water Watch found that since the bill was first introduced in 2023, Bayer has spent $209,750 lobbying for it, including registering seven Iowa lobbyists. That is five times what they spent in the two cycles prior, and nearly double what Bayer spent lobbying in Iowa in the decade prior from 2013 to 2023. The bill failed but will likely be back on the table in next year’s session.

 

The challenge for public health researchers is that this exposure creates a complex web of risk factors that defy simple cause-and-effect relationships. Unlike clear-cut cases of occupational exposure or accidental releases, the kind of chronic, low-level exposure most Iowans face makes definitive connections nearly impossible to establish.

 

"Here in Iowa, the challenge is there's a variety of risk factors and it's not any one thing,” Cwiertny said.

 

For Don Carpenter, this is an unsatisfying reality. He lives near the Maquoketa River, and each summer, he watches as planes spray cornfields that border its waters.

 

“ I just want one person—I don't care which political party—but I just want one person to be like a dog with a bone and just keep harping on this, that we need to do something about it,” he said. “And I don't have faith in any of 'em that they can do that.”

 

Missed a story in this series? Here's where you can find them all:

  • The link between Iowa’s worsening water quality and rising cancer rate

  • Cancer in Iowa: We want to hear your stories

  • The Hot Spot: Why we’re investigating cancer in Iowa 

  • What is behind Iowa’s cancer crisis?

  • Free or low-cost resources for those facing cancer in Iowa

  • What are some cancer screening and treatment options in Iowa?

  • What are the most common types of cancer in Iowa?
 
 

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