How cancer has scrambled Iowa’s midterm politics

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As the debate season kicked off in Iowa’s heated gubernatorial race, one question seemed to animate and, in some ways, unify the candidates.

“What are the immediate and specific steps that you would take to combat Iowa’s cancer crisis?” the moderator asked the Democrat Rob Sand and Republican Zach Lahn, who both said it was a foundational issue for their campaigns — before each accusing the other of not doing enough.

Two weeks later, Iowa’s elevated cancer rates and their potential links to farm pollution came up again, at a debate in the competitive race for Senate.

The subject would have been unimaginable just a few years ago in Iowa, the country’s biggest corn and hog-producing state.

But the role of “Big Ag” has become a political lightning rod amid what is being described as a public health crisis. Iowa suffers from the second-highest cancer rate in the US and is one of only three states where the rate is rising.

For the first time, tackling the environmental causes of cancer has been included in Iowa campaign platforms for both parties. Republicans and Democrats up and down the ticket have staked out positions vowing to take on the issue.

In the governor’s race, Lahn, a farmer-turned-candidate backed by the “Make America Healthy Again” wing of the GOP, and Democrat Sand , a moderate lawyer, have made campaign trail promises to clean up water and regulate chemicals.

In the tight Senate race, Republican Congresswoman Ashley Hinson and Democratic State Representative Josh Turek have wrestled with the question too, both calling this month for more funding to ensure safe drinking water.

This year, nearly $30 million has been spent airing more than 100 campaign ads in Iowa that mention cancer, according to AdImpact data. In the last midterms in 2022, there was just one, backed by a little under $200,000.

“Nine months ago, there was no candidate talking about this except me, and now literally every candidate is featuring it in their campaign,” said Chris Jones, a long-time water quality advocate and now Democratic candidate for state agriculture secretary.

Yet both parties face the awkward challenge of balancing criticism of “Big Ag” practices with Iowa’s economic reliance on the sector. On the left, Jones argues Democrats have not been bold enough to take on Big Ag, ceding ground to Republicans energized by MAHA. He has gone further than any of the other candidates on the ballot in calling for more regulation and a move away from dependence on corn and soybean production.

“You’ve got an issue here that should be a natural issue for Democrats: Clean environment,” he told CNN. But the party was “too chicken to take this issue up,” he said.

Rachel Mummey/Reuters

But divisions within the Republican Party dent its credibility, argues Sara Schreiber of the League of Conservation Voters, with some MAHA voters disillusioned by Trump’s unkept promises for their movement.

“They want elected officials to be responsive” to their cause – health and the environment chief among them – “and they’re not just going to be partisan,” she said.

Iowa’s Health Department attributes much of its soaring cancer rates to several lifestyle factors: Obesity, alcohol and smoking chief among them. But it acknowledged that environmental exposures could play a role, inflaming Iowans who see cancer in their community.

Environmental advocates and some farmers highlight the concentration of nitrate from thousands of tons of livestock manure that leaks into the state’s waters as a key culprit.

A state cancer report showing Iowa’s sobering rates –– the fastest-rising in the country — “was really the game changer,” for average Iowans, said Zach Smith, a farmer and founding member of the Lobe Rangers, an advocacy group that campaigns for stronger government action on environmental toxins.

“This wave of momentum and energy came in. But we need to actually turn it into something meaningful with real legislation,” said Smith, an independent voter. “That’s what we’re interested in — getting the public wound up enough where they’re willing to vote.”

That the state’s Republican Party has emphasized environmental issues this election speaks both to the perceived scale of the problem and the shifting political coalitions.

“It used to be a kind of liberal, tree-hugger type thing,” said James Hepp, another Lobe Rangers founder and a Republican. “It had that stigma where if you talked to any environment, you were a tree hugger, but now I think you’re just an informed citizen trying to do what’s best.”

Many Iowans who spoke to CNN credited the momentum to the MAHA movement, which threw its support behind Lahn, powering his surprise primary victory over the Trump-endorsed GOP Rep. Randy Feenstra.

MAHA Action, a political advocacy group run by longtime Robert F. Kennedy Jr. ally and book publisher Tony Lyons, put $1.5 million towards Lahn’s campaign, and boasts that he was the PAC’s first 2026 endorsement.

“MAHA was the first to believe in Zach Lahn, and the Iowa Republicans proved us right,” Lyons said in a statement. “November is where we prove we can win.”

Charlie Neibergall/Getty Images

Yet there is distrust over the party’s commitment. Lahn has had to wrestle with GOP action in Washington, where the Trump administration ordered more domestic production of pesticides and rolled back a host of environmental regulations.

“I was one of the first people to come out and say that this was the wrong move to sign that executive order,” on more US pesticide production, Lahn told CBS’ “Face the Nation” this month. “I think that if we could give the president the advice on that, that he would understand that better.”

But David Murphy, a MAHA-aligned Democrat who supported RFK Jr.’s presidential run, says he’s skeptical of Lahn because of the disappointing Republican record on MAHA under Trump.

“I fundamentally think that the Trump administration and Republicans have screwed up a major opportunity that RFK Jr. endorsed,” said Murphy, a fifth-generation Iowan who now works on Jones’ agriculture secretary campaign.

In one of the most competitive Senate races in the country, allies of Turek —who was born with Spina Bifida linked to his father’s exposure to Agent Orange in Vietnam — have raised the subject to attack his Republican opponent.

Charlie Neibergall/AP

“Across America, cancer rates are going down, but in Iowa they’re going up. As a doctor, I cannot ignore what is happening,” says Dr. Selden Spencer of Huxley, Iowa, in an ad from a Democratic super PAC with nearly $3 million spent in airtime since September.

It goes on to criticize Hinson for accepting campaign contributions from accused polluters.

Hinson’s campaign did not address the claims in the ad when asked. But this week, she joined with Democratic Rep. Hillary Scholten of Michigan to introduce legislation aimed at improving access to early detection cancer screenings.

“So many Iowa families have been touched by cancer, including mine. Iowa’s rising cancer rates are unacceptable, and we have to do everything we can to reverse this trend,” Hinson wrote on social media .

Republicans are also grappling with internal fractures driven by the MAHA movement, when pro-business and public health interests collide.

One key point of contention is glyphosate — an herbicide commonly known as RoundUp. While many Iowans believe nitrate levels from manure are causing health problems, there are significant divides over the herbicide between farmers and MAHA activists, who say it is also driving cancer rates across the country.

“The reality is that we have all had a lot of exposure to glyphosate,” said Smith, “as a lot of farmers have.” Disagreement over the chemical has created a dividing line that has alienated farmers — many of whom say it is necessary to keep millions of crops safe through each farming season — from the broader MAHA message, he said.

The science on glyphosate and health risks is far from definitive. The Environmental Protection Agency is undergoing a routine review of its safety this year, but the issue has been supercharged by Kennedy, who has a history fighting broad use of the pesticide.

Reflecting the internal divisions, the Republican candidate for Iowa agriculture secretary, Mike Naig, has criticized Lahn, his party’s gubernatorial candidate, on the subject.

“This is more complex than what some want to make it, and I think you’ve got some who have decided it’s a political issue. And I think that can be very dangerous,” he said in August.

Amid fissures on the right, Democrats are leaning into the issue. It’s “ unsurprising that one of the stronger MAHA movements” emerged in Iowa given the incidence of cancer there, said Lauren French of Senate Majority PAC, the Democratic super PAC behind the ads in the Turek-Hinson race.

But while the burgeoning movement is “leaning more Republican at the moment,” she sees an opening. For Democrats, talking about Big Ag chemicals “fits into the larger issue of corruption,” she said, nodding to another major voter concern this cycle.

“The problem for Republicans in Iowa, is that they have a long history of being on the wrong side of this. They chose to align themselves with the companies that are doing the poisoning of the water,” she said.

Some Democrats, however, also face scrutiny. Lahn has accused Sand of being beholden to agricultural interests and accused him of taking money from a donor “ caught polluting your drinking water” — claims vigorously contested by Sand’s campaign.

Leon Neal/Getty Images

In the closing weeks of the race, Sand has held a roundtable with cancer survivors in West Des Moines, discussing his plans to tackle the problem and pledging to “appoint a Cancer Task Force.”

“Rob Sand is the only candidate in the race with a plan to address those concerns,” said Emma O’Brien, the deputy campaign manager. “Meanwhile, Zach Lahn supports the One Big Beautiful Bill, which cuts funding for cancer research, and wants to ban mRNA vaccines, which have been found to be a promising treatment for cancer.”

Lahn’s campaign did not reply to CNN’s requests for comment.

A poll released this week from the Cook Political Report, in partnership with New River Strategies and GS Strategy Group, has Sand with a clear lead over Lahn in the contest for governor.

A CNN poll of polls in Iowa this week shows the Senate race in a dead heat.

CNN’s Nadia Kounang and Ariel Edwards-Levy contributed to this report.

Scott Olson/Getty Images

随着爱荷华州激烈的州长竞选辩论季拉开帷幕，一个问题似乎激发了候选人的热情，并在某种程度上将他们团结起来。

“为了应对爱荷华州的癌症危机，你们会采取哪些立即而具体的措施？”主持人问民主党候选人罗伯·桑德和共和党候选人扎克·拉恩，两人都表示这是他们竞选活动的基础性议题——随后两人都指责对方做得不够。

两周后，在竞争激烈的参议院竞选辩论中，爱荷华州高企的癌症发病率及其与农业污染的潜在联系再次被提及。

几年前，在爱荷华州——美国最大的玉米和生猪生产州——这个话题还是不可想象的。

但在这场被称作公共卫生危机的背景下，“大型农业企业”的角色已成为政治焦点。爱荷华州的癌症发病率位居全美第二，也是仅有的三个癌症发病率呈上升趋势的州之一。

解决癌症的环境成因首次被纳入爱荷华州两党的竞选纲领。共和党和民主党各级候选人都已表明立场，承诺将着手解决这一问题。

在州长竞选中，由农民转型而来的候选人拉恩得到了共和党“让美国再次健康”派的支持，而民主党候选人桑德则是一位温和派律师。两人在竞选过程中都承诺要净化水质并规范化学品。

在竞争激烈的参议院选举中，共和党国会女议员阿什利·欣森和民主党州众议员乔什·图雷克也一直在讨论这个问题，两人本月都呼吁增加资金以确保饮用水安全。

据AdImpact的数据显示，今年爱荷华州已花费近3000万美元投放了100多条提及癌症的竞选广告。而在2022年的中期选举中，只有一条广告提及癌症，且花费略低于20万美元。

“九个月前，除了我之外，没有其他候选人谈论这个问题，而现在几乎每个候选人都在竞选活动中强调这个问题，”长期关注水质问题的克里斯·琼斯说道，他现在是民主党州农业部长候选人。

然而，两党都面临着一个棘手的挑战：既要批评“大型农业”企业的做法，又要兼顾爱荷华州经济对该行业的依赖。左翼人士琼斯认为，民主党人不够大胆，不敢挑战大型农业企业，反而让受“爱荷华州农业和健康法案”（MAHA）鼓舞的共和党人占据了优势。他比其他任何候选人都走得更远，呼吁加强监管，并减少对玉米和大豆生产的依赖。

“清洁环境应该是民主党人理所当然关注的问题，”他告诉CNN。但他表示，民主党“太胆小，不敢正视这个问题”。

瑞秋·穆米/路透社

但环保选民联盟的萨拉·施赖伯认为，共和党内部的分裂损害了其信誉，一些 MAHA 选民对特朗普未能兑现对其运动的承诺感到失望。

“他们希望民选官员能够回应”他们的诉求——其中健康和环境最为重要——“而且他们不会只关注党派问题，”她说。

爱荷华州卫生部门将该州癌症发病率飙升的主要原因归咎于多种生活方式因素：其中肥胖、饮酒和吸烟最为突出。但该部门也承认，环境因素也可能起到一定作用，这加剧了爱荷华州居民对社区癌症病例的担忧。

环保人士和一些农民指出，数千吨牲畜粪便中的硝酸盐渗入该州水域，是造成水体污染的主要原因。

一份州癌症报告显示，爱荷华州的癌症发病率令人警醒——是全国增长最快的——“这真的改变了普通爱荷华州人的生活”，农民兼 Lobe Rangers 创始成员 Zach Smith 说。Lobe Rangers 是一个倡导政府采取更强有力的措施应对环境毒素的组织。

“这股势头和能量确实来了。但我们需要通过真正的立法将其转化为有意义的成果，”独立选民史密斯说。“我们感兴趣的是——如何激发公众的积极性，让他们愿意投票。”

该州共和党在本次选举中强调环境问题，既反映了人们对该问题严重性的认识，也反映了政治联盟的转变。

“以前这有点像是自由派、环保主义者的专属，”另一位洛布护林员组织创始人、共和党人詹姆斯·赫普说道，“人们一提到环保，就会觉得你是环保主义者，但现在我觉得你只是一个了解情况、努力做对环境有益事情的公民。”

许多接受 CNN 采访的爱荷华州人将这股势头归功于 MAHA 运动，该运动全力支持拉恩，助力他在初选中出人意料地战胜了获得特朗普支持的共和党众议员兰迪·芬斯特拉。

由罗伯特·F·肯尼迪二世的长期盟友、图书出版商托尼·莱昂斯运营的政治倡导团体 MAHA Action 向拉恩的竞选活动投入了 150 万美元，并声称他是该政治行动委员会在 2026 年的第一个支持者。

“MAHA是第一个看好扎克·拉恩的组织，爱荷华州的共和党人证明了我们的判断是正确的，”莱昂斯在一份声明中说。“11月将是证明我们能够获胜的时刻。”

查理·尼伯格尔/盖蒂图片社

然而，人们对共和党的承诺仍存有疑虑。拉恩不得不应对共和党在华盛顿的种种举措，特朗普政府下令增加国内杀虫剂产量，并废除了一系列环境法规。

“我是最早站出来说签署那项增加美国农药产量的行政命令是错误之举的人之一，”拉恩本月在接受哥伦比亚广播公司“面对国家”节目采访时表示。“我认为，如果我们能就此向总统提出建议，他会更好地理解这一点。”

但支持小罗伯特·肯尼迪竞选总统的民主党人、与 MAHA 结盟的大卫·墨菲表示，他对拉恩持怀疑态度，因为特朗普领导下的共和党在 MAHA 方面的记录令人失望。

“我从根本上认为，特朗普政府和共和党人搞砸了小罗伯特·肯尼迪支持的一个重大机遇，”墨菲说道。墨菲是爱荷华州第五代居民，现在在琼斯的农业部长竞选团队工作。

在全国竞争最激烈的参议院竞选之一中，图雷克的盟友们利用他父亲在越南接触橙剂后患上的脊柱裂来攻击他的共和党对手。

查理·尼伯格尔/美联社

“全美癌症发病率都在下降，但爱荷华州的癌症发病率却在上升。作为一名医生，我不能对正在发生的事情视而不见。”爱荷华州赫胥黎的塞尔登·斯宾塞医生在一则民主党超级政治行动委员会的广告中说道。该委员会自9月以来已在电视广告上花费了近300万美元。

文章还批评欣森接受了被指控污染者的竞选捐款。

当被问及广告中的说法时，欣森的竞选团队并未作出回应。但本周，她与密歇根州民主党众议员希拉里·斯科尔滕共同提出了一项旨在改善癌症早期筛查服务的法案。

“包括我家在内，爱荷华州的许多家庭都受到了癌症的影响。爱荷华州不断上升的癌症发病率是不可接受的，我们必须尽一切努力扭转这一趋势，”欣森在社交媒体上写道。

共和党人也正努力应对由 MAHA 运动引发的内部分裂，因为亲商利益和公共卫生利益发生了冲突。

争议的焦点之一是草甘膦——一种俗称“农达”的除草剂。虽然许多爱荷华州居民认为粪便中的硝酸盐含量过高会导致健康问题，但农民和MAHA（美国农业健康联盟）的活动人士之间对这种除草剂的看法存在巨大分歧，后者认为草甘膦也是导致全国癌症发病率上升的原因之一。

史密斯说：“事实上，我们都接触过大量的草甘膦，很多农民也是如此。” 他表示，围绕这种化学品的争议造成了分歧，使农民——其中许多人认为，为了确保每个种植季数百万农作物的安全，草甘膦是必要的——与更广泛的“农业和健康行动”（MAHA）理念产生了隔阂。

关于草甘膦及其健康风险的科学研究远未得出定论。美国环境保护署今年正在对其安全性进行例行审查，但肯尼迪州长却让这个问题变得更加引人注目，因为他一直以来都反对广泛使用这种杀虫剂。

为了反映内部的分歧，爱荷华州农业部长共和党候选人迈克·奈格就此问题批评了该党州长候选人拉恩。

“这件事比某些人想的要复杂得多，我认为有些人已经把它当成了一个政治问题。我认为这非常危险，”他八月份时说道。

在右翼内部出现分裂之际，民主党人正积极应对这一问题。参议院多数党政治行动委员会（Senate Majority PAC）的劳伦·弗伦奇表示，考虑到爱荷华州的癌症发病率，“该州出现最强大的MAHA运动之一并不令人意外”。参议院多数党政治行动委员会是民主党超级政治行动委员会，也是图雷克-欣森竞选广告的幕后推手。

但她认为，尽管这场蓬勃发展的运动“目前更倾向于共和党”，但仍存在机会。她表示，对民主党人来说，谈论大型农业化学品问题“与更广泛的腐败问题息息相关”，这也正是本轮选举中选民关注的另一个主要问题。

“爱荷华州共和党人的问题在于，他们在这件事上长期以来都站在错误的一边。他们选择与那些污染水源的公司结盟，”她说。

然而，一些民主党人也面临审查。拉恩指责桑德受制于农业利益集团，并指控他接受了一位“被发现污染饮用水”的捐赠者的捐款——桑德的竞选团队强烈否认了这些指控。

Leon Neal/Getty Images

在竞选的最后几周，桑德在西得梅因与癌症幸存者举行了一次圆桌会议，讨论了他解决这一问题的计划，并承诺“任命一个癌症工作组”。

“罗布·桑德是所有候选人中唯一一位提出方案来解决这些问题的，”竞选副经理艾玛·奥布莱恩说。“与此同时，扎克·拉恩支持‘美好未来法案’，该法案削减了癌症研究经费，他还想禁止mRNA疫苗，而mRNA疫苗已被证明是一种很有前景的癌症治疗方法。”

拉恩竞选团队没有回复 CNN 的置评请求。

本周，库克政治报告与新河战略公司和GS战略集团合作发布的一项民意调查显示，桑德在州长竞选中明显领先于拉恩。

CNN本周对爱荷华州民调的汇总显示，参议院竞选形势胶着。

CNN的Nadia Kounang和Ariel Edwards-Levy对本报道亦有贡献。