Cancer has become the defining issue of Iowa's 2026 midterm elections, with candidates from both parties promising action on rising cancer rates and water quality just days before voters head to the polls Tuesday.
According to The Hill, Iowa now has the second-highest rate of new cancer cases in the nation and is one of the few states where cases are still climbing. The trend has upended the usual political playbook, putting water quality, farm chemicals, and public health at the center of races from the governor's mansion to the House.
What Iowa's cancer numbers show
Iowa's cancer rates have risen sharply enough in recent years to make the state a dangerous outlier nationally, The New York Times reported, and mounting public concern has pushed the issue to the top of the campaign agenda ahead of the midterms. Drinking water quality and potential environmental risks are now in the spotlight in races statewide, Medical Daily reported.
Republican gubernatorial nominee Zach Lahn made the stakes plain during a recent 'Face the Nation' appearance.
'We have the fastest rate of new cancer anywhere in the country, number one. If you move out of the state of Iowa, to, say, a state like Nevada, your chance of getting cancer any given year goes down by 40 percent,' Lahn said.
How MAHA reshaped the governor's race
Lahn's willingness to talk about cancer and vow to clean Iowa's water and regulate chemicals marks a sharp departure from traditional Republican positions in a Corn Belt state. The shift reflects the growing influence of the Make America Healthy Again movement championed by Health Secretary Robert F. Kennedy Jr.
MAHA Action, the Kennedy-aligned advocacy group run by Tony Lyons, endorsed Lahn early, and he rode that support to a primary win over Rep. Randy Feenstra, an established officeholder who had President Donald Trump's endorsement. Kennedy has made repeated trips to Iowa to boost GOP candidates, most recently headlining a rally featuring Lahn and Joe Mitchell, who is running for the House seat Rep. Ashley Hinson is vacating to run for Senate.
'I love Zach, because we need to figure out a way to feed ourselves in this country, make this country the breadbasket of the world without degrading our soils and without poisoning our children,' Kennedy said at the rally.
Lahn has also adopted other MAHA positions, promising to end vaccine mandates in schools and ban the COVID-19 vaccine.
Karen Kedrowski, a political science professor at Iowa State University, said the issue resonates because it touches nearly every family.
'When you start talking about cancer, everybody knows somebody, or a friend of a friend, or someone who has had cancer,' Kedrowski said. 'The cancer piece really becomes salient because it's so common and kind of top of mind.'
Can Kennedy win over independent voters?
Republicans are betting that Kennedy can bring voters to the polls, particularly those without strong party ties. Timothy Hagle, a political science professor at the University of Iowa, said voters who support the agriculture industry are unlikely to abandon the GOP, but Kennedy may persuade no-party voters.
'The idea may be that RFK Jr .... can maybe appeal to more of those no-party voters,' Hagle told The Hill.
Cancer crosses party lines down the ballot
Environmental politics in Iowa no longer split neatly along party lines. Democratic agriculture secretary candidate Chris Jones is running on a clean water platform, has been endorsed by Sen. Bernie Sanders of Vermont, and counts Dave Murphy, a veteran of Kennedy's presidential campaign, as his finance director. Jones said having a Republican also speaking out on water quality 'makes me look less like a renegade.'
'This cancer issue is resonating with people, and almost everyone has a story here of a family member or someone else that has met an early demise,' Jones told The Hill.
Jones's opponent, incumbent Agriculture Secretary Mike Naig, previously worked for Monsanto, whose Roundup weedkiller has become a prime MAHA target. Murphy argued that even with MAHA candidates in the race, Democrats have the stronger record on water quality, though he conceded Lahn may keep some votes that would otherwise flow from Feenstra to Democrat Rob Sand.
The League of Conservation Voters Victory Fund is targeting Rep. Mariannette Miller-Meeks with ads over her votes on water pollution, healthcare cuts, and reductions to cancer research funding.
'Republicans have had a chance to show up and deliver on promises from everything from lowering cost to the things that they said they would do around MAHA voters' concerns, and I think that they've failed miserably,' said Sara Schreiber, senior vice president of campaigns at the group.
What to watch on Election Day
Tuesday's midterms feature a stacked ballot: the governor's race between Lahn and Sand, the Senate contest between Hinson and state Rep. Josh Turek, and several competitive House seats. The Washington Sun reported that the cancer crisis has roiled races up and down the ballot, with Sand campaigning on expanding the state's wetlands as part of his plan to address the problem.
Affordability is also weighing on voters, including high diesel prices that raise costs for farmers, a frustration intensified by the administration's foreign tariffs and the war in Iran.
Jeff Hutt, who worked on Kennedy's presidential campaign, said the rural vote can no longer be taken for granted. 'Now that Republican policies, through support of Big Ag, through use of pesticides, [are] starting to affect these rural communities negatively, I think that you're going to see a shift in the Republican Party about how they treat these issues,' he said.
Whatever the results, Hutt sees the race itself as a victory for the movement.
'In my mind, MAHA has already won this election. It doesn't matter who comes out with the most votes at the end,' Hutt said.
Frequently asked questions
Where does Iowa rank nationally in cancer rates?
Iowa has the second-highest rate of new cancer cases in the United States and is one of the few states where cancer cases are still rising, according to The Hill.
Why is cancer a campaign issue in 2026?
Candidates from both parties, including Republican gubernatorial nominee Zach Lahn, have made cancer rates, water quality, and chemical regulation central to their platforms, reflecting the influence of the MAHA movement.
Which Iowa races are competitive this year?
The governor's race between Zach Lahn and Rob Sand, the Senate race between Ashley Hinson and Josh Turek, and several competitive House seats are all on Tuesday's ballot.