2026-09-29T10:08:31.709Z / 路透社
9月29日（路透社）——在艾奥瓦州博览会上的舞台上，美国共和党众议员扎克·纳恩在妻子和六个子女中的四位陪同下，动情地谈到了一个在他这场竞争激烈的中期选举中成为核心关切的议题：癌症。
“听着，我母亲是癌症幸存者。我知道癌症影响了我们所有人，我们的家人、我们的朋友，”他在8月的这场活动中说道，并吹嘘自己为艾奥瓦州第三国会选区争取到了更多癌症筛查资金。
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就在两天前，他在11月选举中的民主党挑战者、州参议员莎拉·特龙·加里奥特也曾在同一个舞台上谈论癌症议题。
“我们都知道艾奥瓦州存在癌症问题。我们所有人都有朋友、邻居，甚至我们自己也曾经历过癌症，”她说。
他们并非唯一谈及这一议题的候选人：出席博览会的六位国会众议院、参议院和州长候选人中有五位都谈到了艾奥瓦州的高癌症发病率，这反映出今年癌症已成为两党竞选的共同核心议题。
候选人、倡导组织和战略师表示，该州的癌症发病率正在上升——仅次于肯塔基州，位居全美第二——这一问题首次与生活成本等民生议题一道，成为了重大竞选议题。
尽管癌症的病因往往复杂且尚未完全明确，但艾奥瓦州选民的担忧在一定程度上源于他们担心该州日益严重的硝酸盐和其他化学品造成的水污染，可能是病例激增的原因。
路透社对竞选材料的审查显示，艾奥瓦州国会和州长竞选的每位主要候选人最近都在演讲、社交媒体帖子或其官方网站上谈到了他们应对癌症的计划。
候选人承诺采取一系列行动，从增加癌症筛查到改善水质监测。民主党人利用这一议题推动扩大医疗保健获取渠道，而共和党人则倡导更多的治疗选择和研究资金。
根据追踪和研究艾奥瓦州癌症病例的艾奥瓦癌症登记处的报告，在经历了十多年的下降后，艾奥瓦州的癌症发病率于2014年开始上升，自2023年以来一直位居全美第二。
根据美国国立卫生研究院下属的国家癌症研究所的数据，艾奥瓦州是全美仅有的三个癌症发病率持续上升的州之一，这一趋势由肺癌、前列腺癌和乳腺癌等癌症发病率上升推动。
艾奥瓦大学政治学家蒂姆·哈格尔表示，他不记得癌症曾在以往的选举中成为如此重要的关切议题。他说，今年这一议题得以凸显，部分原因是它与选民对其他健康问题的担忧挂钩，比如共和党支持的削减针对低收入美国人的联邦医疗项目医疗补助计划的资金。
癌症议题的政治博弈
一些民主党人利用对癌症议题的关注，抨击现任共和党议员支持唐纳德·特朗普总统2025年的财税法案，该法案通过扩大受益人的工作要求等改革削减了医疗补助计划的资金。
参选参议院议员的民主党人乔希·图雷克在艾奥瓦州博览会上的讲话中批评其共和党对手、代表艾奥瓦州第二国会选区的阿什利·辛森“（投票）让11万艾奥瓦州民众失去医疗保障，而该州正面临癌症和医疗保健危机”。
独立健康政策研究组织凯泽家庭基金会估计，由于特朗普的财税法案带来的改革，到2034年将有大约10万艾奥瓦州民众失去医疗保险。
辛森则指出，她支持旨在改善农村地区移动癌症筛查和乳腺X光机可及性的立法，以及旨在改善水质的保护工作。
2026年9月10日，美国艾奥瓦州西米苏拉，艾奥瓦环境委员会政策与项目高级主任凯丽·约翰森在一场新闻发布会上发言，该发布会旨在启动“保护水源 预防癌症”运动，这是由艾奥瓦环境委员会领导的全州性联盟活动。路透社/蕾切尔·芒米
“我有两位姑姑和我的祖母都因癌症去世。这对我而言是切身之痛，”她在给路透社的一封电子邮件中说道。
图雷克和其他民主党人，如在艾奥瓦州第一选区参选的克里斯蒂娜·博安南，表示他们将推动撤销这些削减措施，并呼吁联邦政府进一步投入癌症研究资金。
倡导旨在终结癌症政策的美国癌症协会癌症行动网络艾奥瓦分会表示，选民对这一议题的参与度更高，所有人都在质疑水质是否与癌症发病率有关。
“（这）是所有人心中的头等大事，”政府关系主任杰基·凯尔说道，并补充道癌症的病因复杂，并非仅由单一因素导致。
为约翰·霍普金斯大学可持续未来中心（一家专注于农业的公共卫生中心）工作的民调公司GQR于7月代表该中心开展了一项民调，对800名可能在11月选举中投票的艾奥瓦州选民进行了调查，结果显示60%的选民将水质列为他们投票时关注的五大议题之一。
相关科学研究
许多艾奥瓦州民众将他们对癌症的担忧与该州水中高含量的硝酸盐联系起来，而硝酸盐污染往往是化肥冲刷进入河流和地下水造成的。根据美国农业部的数据，艾奥瓦州约85%的土地为农田，其中大部分种植玉米等对化肥需求量大的作物。
艾奥瓦州主要水道中的硝酸盐浓度在过去50年里翻了一番，且经常超过美国环境保护署设定的标准，根据艾奥瓦州波尔克县监事会2025年委托发布的一份全州性报告。
行业贸易组织肥料研究所拒绝为本文置评。
科学家们尚未就硝酸盐污染的饮用水带来的癌症风险达成共识。包括艾奥瓦大学和国家癌症研究所开展的一些研究发现，硝酸盐污染与更高的癌症发病率或死亡率存在关联，而其他研究则未发现这一关联。
即将卸任的共和党州长金·雷诺兹于2025年委托该州卫生与人类服务部和艾奥瓦大学开展一项为期两年的研究，以探究该州癌症发病率大幅上升的原因。
今年2月发布的一份中期报告发现，艾奥瓦州的人口统计和行为风险因素与邻国相似，尽管该州在酗酒和肥胖等癌症风险因素方面排名靠前。该报告未就癌症发病率上升的原因给出明确结论。
艾奥瓦州农民联盟表示，有关癌症、受污染水源和农药使用之间可能存在关联的担忧，是与艾奥瓦州农村民众讨论时反复出现的主题。
该联盟主席亚伦·莱曼告诉路透社，应重点关注扩大农民的选择范围，以减少径流、改善水质，同时让农业体系的所有相关方承担责任，并将生产者置于任何长期解决方案的核心位置。
艾奥瓦州曾通过2013年的《营养减少战略》努力减少径流，该战略旨在遏制流入密西西比河的污染，但环保组织和艾奥瓦州农民联盟表示，这项自愿性计划并未取得足够成效。
癌症发病率上升的原因尚未明确，但这并未减轻选民的担忧。今年8月，在五县巡回宣讲期间，民主党候选人博安南表示，那些对癌症病例增加感到担忧的选民告诉她，水质是他们最关注的议题之一。
“我与水处理厂运营商、参与保护工作的人士交谈过，我还与普通民众、担心孩子用水的家长交谈过，”她说。“这无疑正在成为一个重大议题。”
莱娅·道格拉斯在华盛顿报道，罗斯·科尔文和阿利斯泰尔·贝尔编辑
In Iowa, soaring cancer rates emerge as a key midterms issue
2026-09-29T10:08:31.709Z / Reuters
Sept 29 (Reuters) – Pacing a stage at the Iowa State Fair, flanked by his wife and four of their six children, Republican US Congressman Zach Nunn spoke passionately about an issue that has emerged as a key concern in his competitive midterms race: cancer.
“Look, my mom is a survivor. I know that it has touched all of us, our family, our friends,” he said at the August event, touting his efforts to bring more money for cancer screening to Iowa’s third congressional district.
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Two days before, his Democratic challenger in November’s election, state Senator Sarah Trone Garriott, had discussed cancer on the same stage.
“We know Iowa has a cancer problem. All of us have friends, neighbors, maybe we’ve even experienced it ourselves,” she said.
They were not the only hopefuls to talk about it: five of the six House, Senate and gubernatorial candidates who appeared at the fair discussed Iowa’s high cancer rates, reflecting the extent to which the disease has become a bipartisan campaign issue this year.
Candidates, advocacy groups and strategists say the state’s rising cancer rate – the second highest in the country behind Kentucky – has for the first time emerged as a major issue alongside kitchen-table concerns such as the cost of living.
While the causes of cancer are often complex and not well understood, Iowa voters’ concerns are driven in part by worries that the state’s worsening water pollution from nitrates and other chemicals may be to blame for a spike in cases.
Every major candidate in Iowa’s competitive races for Congress and the state governorship has talked about their plans to tackle cancer in recent speeches, social media posts or on their websites, according to a Reuters review of campaign materials.
The candidates have pledged a range of actions from increasing cancer screening to improving water quality monitoring. Democrats have used the issue to push for expanded healthcare access, while Republicans have promoted greater treatment options and research funding.
After more than a decade of decline, Iowa’s cancer rate began to rise in 2014, and it has had the second-highest cancer rate in the nation since 2023, according to reports by the Iowa Cancer Registry, which tracks and studies cancer cases among Iowans.
It is one of just three states where cancer is rising, driven by higher rates of lung, prostate and breast cancers, among others, according to the National Cancer Institute at the National Institutes of Health.
Tim Hagle, a political scientist at the University of Iowa, said he can’t remember cancer ever being such a significant concern in past elections. The issue has taken hold in part this year because it ties into voter concern about other health issues, like Republican-backed cuts to Medicaid, the federal health program for lower-income Americans, he said.
THE POLITICS OF CANCER
Some Democrats are using the focus on cancer to attack incumbent Republicans for supporting President Donald Trump’s 2025 tax and spending law, which made cuts to Medicaid by expanding work requirements for beneficiaries, among other changes.
Josh Turek, a Democrat running for Senate, in his remarks at the Iowa State Fair criticized his Republican opponent Ashley Hinson, who represents Iowa’s second congressional district, for “(voting) for 110,000 Iowans to lose their healthcare in a state with a cancer and a healthcare crisis.”
Independent health policy research group KFF estimates that around 100,000 Iowans could lose health insurance by 2034 due to changes under Trump’s tax and spending law.
Hinson pointed to her support for legislation that would improve access to mobile cancer screening and mammogram machines in rural areas, and for conservation efforts to improve water quality.
Kerri Johannsen, Senior Director of Policy and Programs for the Iowa Environmental Council, speaks during a press conference to launch the Protect Water Prevent Cancer campaign, a statewide coalition led by the Iowa Environmental Council, in West Des Moines, Iowa, U.S. September 10, 2026. REUTERS/Rachel Mummey
“I have lost two aunts and my grandmother to cancer. It’s personal to me,” she said in an email to Reuters.
Turek and other Democrats, like Christina Bohannan, who is running in Iowa’s first district, have said they would push to reverse those cuts and campaign for further federal investment in cancer research.
Iowa’s chapter of the American Cancer Society Cancer Action Network, which advocates for policies to end cancer, says voters are more engaged on the issue and that all are raising the question of whether water quality is linked to cancer rates.
“(It) is top of mind for everybody,” government relations director Jackie Cale said, adding that the causes of cancer are complex and not limited to just one thing.
A July poll conducted by GQR, a polling firm that works with Democrats, on behalf of the Johns Hopkins Center for a Livable Future, a public health center focused on agriculture, found that 60% of 800 likely Iowa voters ranked water quality among their top five issues in the November elections.
THE SCIENCE
Many Iowans tie their cancer concerns to high nitrate levels in the state’s water, which can occur when fertilizer washes into rivers and groundwater. About 85% of Iowa is farmland, much of it dedicated to fertilizer-heavy crops like corn, according to the US Department of Agriculture.
The concentration of nitrates in Iowa’s main waterways doubled over the past 50 years and regularly exceeds levels set by the Environmental Protection Agency, according to a 2025 statewide report commissioned by Iowa’s Polk County Board of Supervisors.
The Fertilizer Institute, an industry trade group, declined to comment for this story.
Scientists have not reached a consensus on the cancer risk posed by nitrate-contaminated drinking water. Some studies, including by the University of Iowa and the National Cancer Institute, have found associations with higher cancer rates or mortality, while others have not.
Outgoing Republican Governor Kim Reynolds in 2025 commissioned a two-year study by the state’s Department of Health and Human Services and the University of Iowa to examine why the state has seen such a rise in cancer.
An interim report released in February found that Iowa has similar demographic and behavioral risk factors as neighboring states, though it is among the highest-ranked states in cancer risk factors like binge drinking and obesity. The report did not provide firm conclusions about the rise.
The Iowa Farmers Union said concerns about possible links between cancer, contaminated water and pesticide use are a recurring theme in discussions with rural Iowans.
The group’s president, Aaron Lehman, told Reuters that the focus should be on expanding farmers’ options to reduce runoff and improve water quality, while holding all parts of the agricultural system accountable and placing producers at the center of any long-term solution.
Iowa has attempted to reduce runoff through its 2013 Nutrient Reduction Strategy, which aimed to curb pollution into the Mississippi River, but environmental groups and the Iowa Farmers Union have said the voluntary plan hasn’t done enough.
The uncertainty over the cause of the increase in the cancer rate has not diminished voter concerns. During a five-county tour this August, Bohannan, the Democratic candidate, said voters worried about the rise of cancer cases told her water quality was among their top issues.
“I talked to water treatment plant operators, people involved in conservation, I talked to everyday people, parents who are worried about the water with their kids,” she said. “It is definitely becoming a major issue.”
Reporting by Leah Douglas in Washington, editing by Ross Colvin and Alistair Bell