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Kentucky & Louisville: Colon Cancer at a Glance

Kentucky’s National Standing — It’s the Worst

Kentucky has the highest rate of colorectal cancer in the nation, according to the CDC, and it is the third leading cause of cancer death in both men and women. 

Colorectal cancer incidence rates in Kentucky hit approximately 45 per 100,000 people — tied with Mississippi for the highest in the U.S. — compared to as low as 28 per 100,000 in Utah. Mortality rates follow the same pattern, with Kentucky among the worst in the nation. 

CRC occurrence is highest in Appalachia, the South, and parts of the Midwest — with differences largely driven by smoking, excess body weight, and gaps in access to quality screening and treatment. 

The Younger Patient Problem

Kentucky is following a national trend: a notable rise in colon cancer cases among younger people. Norton Cancer Institute oncologist Dr. Douglas Nelson points to the microbiome — specifically, chronic gut inflammation driven by diet and lifestyle — as a likely contributing factor. 

Overall Kentucky Cancer Burden

Kentucky’s new cancer rate runs 13% higher than the national average, and in 2019 alone, nearly 29,000 new cancer cases were reported — a number that has grown steadily since the early 2000s. 

Screening Rates

The American Cancer Society recommends screenings starting at age 45 for average-risk individuals. Colonoscopy remains the gold standard, since most colon cancers begin as polyps that develop into cancer over several years — making early detection the most effective intervention. 

Survival Rates

The five-year survival rate for stage 1 and stage 2 colon cancer is 90%.  However, 5-year survival drops to just 15% for distant-stage disease — making screening timing everything. 

Why Louisville/Kentucky Is So High

The drivers are well-documented: high smoking rates, elevated obesity and sedentary lifestyle prevalence, processed food diet, lower average access to preventive care, and genetic factors concentrated in certain populations. Louisville gastroenterologist Dr. Whitney Jones — founder of the Colon Cancer Prevention Project — has been a national advocate for genetic testing to identify high-risk individuals earlier and lower population-level cancer outcomes.  Kentucky recently passed legislation requiring insurance to cover genetic cancer tests when recommended by a physician.