The 99 Counties Project

2025 Cancer in Iowa Report

Because cancer has once again struck in my family, I got knocked off track in my writings here. Apologies to my readers, as I said in previous essays, March is not a great month if you are a Crabtree from Cerro Gordo County.

I also made an executive decision. I am rearranging the schedule of stories that I am undertaking in this series. First, it will help me restart both this series and my writings here on Substack. Second, I have questions, as do many of my readers and many other Iowans, about the inability of the Iowa Cancer Registry, Iowa’s research institutions and the state government to answer the sincere and burning question so many Iowans are asking — why are so many of us, our families, friends and communities, suffering at the hands of Iowa’s cancer crisis?

However, before I go into that I want to utilize this essay to sing some praises for Dr. Mary Charlton, the University of Iowa College of Public Health and the Iowa Cancer Registry. There will be another day and another essay (or two) here to discuss what the ICR, U of I CPH and the state of Iowa can and should do better. Today we need to talk about something they are doing well. I believe in these times when so many things are assailed and uncertain, when someone stands out in positive ways, it is incumbent upon me to point that out too. Perhaps I simply do not always want to be critical, but I argue that it is vital.

I appreciate Dr. Mary Charlton and her staff at the U of I CPH and the Iowa Cancer Registry, particularly in the area of sharing data and information with the public. I have written before about the war on public information being waged in Iowa and just about everywhere in the United States — Too Many Secrets. I have also written about the fact that I believe that Dr. Charlton, the CPH and the Iowa Cancer Registry stand out dramatically when it comes to disseminating the data and information they compile and study — Mea Culpa Professor Charlton, Mea Culpa.

My views in this regard are not universally popular. I understand this. Some of my friends, allies and readers have expressed to me their disappointment with the Registry and with Dr. Charlton. I too have hard questions to ask, that I did ask of Dr. Charlton when we spoke this month. But that is, I believe, precisely the point and why I chose to change the order of my series on the 2025 Cancer in Iowa report. Before painting the entire report and the ICR with one brush, it is important that we look again, briefly at least, at the ICR’s 99 Counties Project.

In my Mea Culpa post I wrote this:

“The goal of the 99 Counties Project is to provide local partners with actionable cancer data specific to their county so they can address cancer concerns and promote healthier communities,” says Mary Charlton, professor of epidemiology at the University of Iowa and director of the Iowa Cancer Registry (excerpt from Iowa Cancer Registry 99 Counties webpage).

In other words, sharing information with the people of Iowa is what Professor Charlton and her associates at the U of Iowa CPH and Iowa Cancer Registry do, virtually every day.

Professor Charlton, I apologize. You and your staff are the first people that I have dealt with these last two years who – when asked to share information with me, and through me, other Iowans – have not resisted, delayed, obfuscated and withheld information that the public has a right to know. I said that the opacity of governmental officials as well as those at public institutions is universal. You have proven to me that is not true. And I apologize, sincerely, for lumping you and your staff in with the others.

I must say, however, that the Iowa Cancer Registry Director and her staff are still the only example of officials and employees at a public institution that have demonstrated a commitment to the freedom of information and the value that information has to the people of Iowa, and people everywhere else too.

The 99 Counties Project is supported by funding from the National Cancer Institute (NCI). When the White House is actively trying to dismantle the National Institutes of Health (NIH), the NCI and just about every other research institution they can, could there be any more important time to laud researchers and scientists that are not only continuing to do their research but also doing a markedly better job that others about getting that information into the hands of all of the people that need it? I, for one, do not believe that there could be a more important time.

Dr. Charlton, I applaud your efforts and those of your colleagues at the U of Iowa CPH and the Iowa Cancer Registry for your 99 Counties Project and your willingness to take your 2025 Cancer in Iowa report out to Iowans that so desperately want answers to why so many in our families and communities are suffering with Iowa’s cancer crisis.

In case my readers are not aware, the 99 Counties Project presentations that have been scheduled, or already presented, are all calendared on the 99 Counties Project page, and I highly recommend that you all look up and plug into these data presentations. And make a plan to go to your county presentation, get the information first-hand and ask your questions. The ICR needs to hear from you.

I have attended one 99 Counties Project presentation (Bremer County) and reviewed the presentations and data presented at the others that have already occurred. I promise you, if you show up and ask your questions, regardless of how hard-hitting, you will at a minimum start a meaningful dialogue with ICR staff that will be helpful to you and will help shape their work for the coming year as well.

Stand up, plug in, find out and speak out with what you learn.

Tomorrow I will write about the questions surrounding environmental risk factors and Iowa’s cancer crisis and rising cancer rates — e.g. polluted and contaminated water, in Iowa — and that essay will likely not sound much like applause. It will, however, be as fair as I can make it.

Dr. Charlton, since we spoke earlier in March, another member of my family has received a cancer diagnosis, adding another Iowan to the Iowa Cancer Registry.

Casus Belli - Though the Heavens Fall... by John Crabtree

Please keep talking about your research and data, keep sharing the information as broadly as you are able. Make the 99 Counties Project as consequential as possible.

Challenging though it may be, when it comes to answering difficult questions about Iowa’s cancer crisis, do more, and do better Dr. Charlton. Iowans deserve answers to their questions, especially the big one I mentioned above.

And so do my brothers and sisters.