Access to comprehensive cancer care in the U.S. is as varied across state lines as cancer incidence and mortality. The geographic distribution of the nation’s most research-intensive organizations — National Cancer Institute-designated cancer centers — does not align neatly with patterns of cancer burden.
NCI-designated cancer centers are required to meet rigorous standards and dedicate a significant amount of their resources toward research that yields measurable advancement in the prevention, diagnosis and treatment of cancer, while also providing comprehensive clinical oncology care.
For this reason, these facilities are partially funded by the federal government. Outside of federal funding, these organizations often engage in philanthropic efforts to sustain operations while others rely on long-standing partnerships and academic affiliations.
The presence of an NCI-designated cancer center reflects research intensity and infrastructure, but cancer outcomes are influenced by broader factors, including screening rates, socioeconomic and geographic conditions, behavioral risk factors and Medicaid coverage.
There are 73 NCI-designated cancer centers located across 37 states and the District of Columbia: nine clinical cancer centers, seven basic laboratory cancer centers and 57 comprehensive cancer centers.
Becker’s compared the American Cancer Society’s state-level cancer incidence and mortality data to locations of the top U.S. cancer centers, excluding basic laboratory facilities.
Here are five things to know:
- Between 2018 and 2022, 31 states had cancer incidence rates higher than the national average. Of those, 19 states were home to at least one NCI-designated cancer center.
For the same time period, 20 states had cancer incidence rates lower than the national average. Of those, 16 states and Washington, D.C., were home to at least one NCI-designated cancer center.
In other words, nearly 40% of states with higher-than-average cancer incidence had no NCI-designated cancer center, compared with 15% of states with lower-than-average incidence.
- There was little difference in mortality rates, with 30.4% of states with lower-than-average cancer mortality rates having at-least one in-state NCI-designated cancer center compared to 32.1% of states with higher-than-average mortality.
- States with the highest populations, per the US Census Bureau’s 2025 data, had the most in-state NCI-designated cancer centers.
- California has eight in-state cancer centers and lower-than-average cancer incidence and mortality.
- New York has seven in-state cancer centers and higher-than-average cancer incidence but lower-than-average mortality.
- Florida has four in-state cancer centers and higher-than-average cancer incidence but lower-than-average mortality.
- Texas has four in-state cancer centers and lower-than-average rates of cancer incidence and mortality.
- Pennsylvania also has four in-state cancer centers but has higher-than-average rates of cancer incidence and mortality.
- California has eight in-state cancer centers and lower-than-average cancer incidence and mortality.
- States with the highest cancer incidence rates between 2018 and 2022 — Kentucky, West Virginia, Iowa, Louisiana and Florida — were more rural and located in the South or Appalachia.
NCI-designated cancer centers were not located in two of those states, West Virginia and Louisiana. - Here are the cancer incidence and death rates of all states and the District of Columbia alongside the number of NCI-designated cancer centers in each state:
| Incidence rate per 100,000(2018-2022) | Death rate per 100,000(2019-2023) | Number of in-state NCI-designated cancer centers | |
| National | 460.6 | 145.4 | 66 |
| Alabama | 435.7 | 159.1 | 1 |
| Alaska | 450.6 | 148.9 | 0 |
| Arizona | 409.9 | 132.3 | 2 |
| Arkansas | 487.0 | 168.5 | 0 |
| California | 415.8 | 131.9 | 8 |
| Colorado | 402.9 | 127.6 | 1 |
| Connecticut | 491.2 | 133.3 | 1 |
| Delaware | 482.7 | 156.0 | 0 |
| District of Columbia | 426.5 | 144.7 | 1 |
| Florida | 496.1 | 138.3 | 4 |
| Georgia | 478.6 | 150.7 | 1 |
| Hawaii | 410.8 | 121.6 | 1 |
| Idaho | 485.5 | 138.6 | 0 |
| Illinois | 474.8 | 149.7 | 2 |
| Indiana | 487.0 | 165.4 | 1 |
| Iowa | 506.7 | 149.2 | 1 |
| Kansas | 461.2 | 152.6 | 1 |
| Kentucky | 528.3 | 180.4 | 1 |
| Louisiana | 497.0 | 165.1 | 0 |
| Maine | 495.1 | 159.1 | 0 |
| Maryland | 459.0 | 141.2 | 2 |
| Massachusetts | 453.5 | 136.1 | 2 |
| Michigan | 457.8 | 157.4 | 2 |
| Minnesota | 495.7 | 141.4 | 2 |
| Mississippi | 485.3 | 149.0 | 0 |
| Missouri | 483.5 | 162.2 | 1 |
| Montana | 465.4 | 141.8 | 0 |
| Nebraska | 456.8 | 148.7 | 1 |
| Nevada | 398.4 | 144.8 | 0 |
| New Hampshire | 485.9 | 145.2 | 1 |
| New Jersey | 487.0 | 130.1 | 1 |
| New Mexico | 388.0 | 131.4 | 1 |
| New York | 473.7 | 125.6 | 7 |
| North Carolina | 493.0 | 154.1 | 3 |
| North Dakota | 464.3 | 136.4 | 0 |
| Ohio | 484.0 | 160.3 | 2 |
| Oklahoma | 463.1 | 174.3 | 1 |
| Oregon | 431.1 | 149.1 | 1 |
| Pennsylvania | 464.8 | 151.6 | 4 |
| Rhode Island | 467.2 | 142.0 | 0 |
| South Carolina | 446.9 | 156.8 | 1 |
| South Dakota | 477.8 | 151.1 | 0 |
| Tennessee | 465.2 | 167.7 | 2 |
| Texas | 446.5 | 142.9 | 4 |
| Utah | 427.9 | 121.5 | 1 |
| Vermont | 462.7 | 150.6 | 0 |
| Virginia | 423.1 | 147.9 | 2 |
| Washington | 448.3 | 144.8 | 1 |
| West Virginia | 511.5 | 177.9 | 0 |
| Wisconsin | 480.7 | 148.5 | 1 |
| Wyoming | 408.8 | 144.0 | 0 |
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