State of Cancer: How the 99-county tour for the Iowa Cancer Registry began and what it’s doing

In 2024, reports placed Palo Alto County as having one of the highest rates of cancer in the U.S.Reporters began calling Sarah Strohman, who runs the county health department.One got her attention.”She reached out to me and said, ‘You know, I have interviewed several people in your county, and they don’t feel like anything is being done about this,'” Strohman said. “So, red flag for me.”A few phone calls later, Strohman found Mary Charlton. She runs the Iowa Cancer Registry.Charlton tracks every cancer case in the state. “They asked us to do kind of a deeper dive into their data,” Charlton said.The Iowa Cancer Registry publishes the annual Cancer in Iowa report. In 2023, that report set off alarm bells when Iowa came in No. 2 in new cancer cases.”It was always just assumed that we were comparable to others, and so that was kind of a big eye opener for us,” Strohman said. The two planned a local event for November 2024. The local hospital provided lunch for attendees.”We didn’t realize until the next day, when the newspaper covered it, that there were over 150 people in the room,” Charlton said.That one event led to the registry’s 99-County Tour, giving Iowans local-level details about the disease.”People are scared and concerned, and we want to talk with people,” she said. On Jan. 13, Charlton reached the halfway point.The Cancer in Polk County community event, the 45th one, brought several hundred people to Drake University, and 150 more participated virtually.”The amount of people that show up, the passion that they have, the great questions that they have and, you know, these counties that are in rural areas, they don’t have a lot of resources, but they do have a lot of engagement,” Charlton said.For Palo Alto, that meant action on lung cancer.And one of the leading causes: radon. That’s a colorless, odorless gas.Iowa sits on top of a huge amount of radon. A grant launched efforts for the county.”We were able to provide 800 free test kits in our county, and then we started getting test results back. We have some scary numbers in our county,” Strohman said.They had a few readings in the 30s and 20s. Four picocuries is the Environmental Protection Agency standard. Anything at that level or higher should be addressed with a mitigation system, the agency recommends.”We are able to reduce those risks just by helping with the mitigation,” Strohman said.With grants, the county got them in 64 homes.Back in Polk County, health officials have started to take steps, announcing a Cancer Prevention Coalition with residents and experts.”It’s all of our job to kind of figure out what we’re going to do on something that’s so impactful on our community’s health,” said Juliann Van Liew, the Polk County Health Department director.Van Liew sees an area for attention right away. Rates of the disease affect more Black residents in Polk County than any other group.”I think our Black population is really where we need to focus the most, to be quite frank with you. We have disparities in other populations as well, and we will also target interventions for them,” Van Liew said.The Jan. 13 event hosted by the department and the Harkin Institute helped show areas for potential action.”The 99 counties project has been able to be a driver of kickstarting conversations that maybe wouldn’t have already been kickstarted without that,” Van Liew said.Medical professionals and public health workers point to Iowans also as being able to take action through exercise, diet, limiting alcohol consumption and wearing sunscreen.Those steps also come up on the 99-County tour events. Public health leaders say they know Iowans want answers.”I hope that people understand that cancer’s complicated,” Charlton said. “There are things you can do individually. There are also things we need to do as a community or as a state that can really help address our cancer rates.”