In January, State Sen. Catelynn Dolly stood at the podium on the Senate floor in front of colleagues representing all of Iowa. She told them she planned to speak candidly about subjects both “personal and political.” Behind her, members of Congress and staff appeared to be only half listening, looking at laptops or flipping through documents.
When she told them she had been diagnosed with uterine cancer, they looked surprised. Dolly, 38, was just weeks into his first term as a state senator.
“From the moment I said ‘cancer,’ it was like everyone had their attention all at once,” she told The Sentient over the phone. This comes weeks after she spoke in front of her colleagues and days after publicly announcing that her surgery was successful and that she is now cancer-free.
Dolly’s experience as a cancer patient is one shared by many in Iowa in the midst of the cancer crisis.
Iowa has the fastest growing rate of new cancers in the United States, but the national cancer rate continues to decline. In the state, the cancer incidence rate for people under 50 is unusually high compared to the national average and is increasing. Uterine cancer rates are also on the rise in Iowa. The US economy as a whole remains stable. Iowa County, located just west of Iowa City, has a uterine cancer rate nearly twice the national average.
It is always complicated to definitively answer questions about the causes of cancer. But a recent report found that Iowa’s high levels of nitrates, pesticides, PFAS or “forever chemicals,” and radon are associated with cancer risk. High levels of nitrates in drinking water are often caused by over-application of fertilizers or synthetic fertilizers on farms. Iowa is the state with the most factory farms, and the animals on those farms produce 110 billion pounds of fertilizer annually.
Outside of Iowa, nitrate-contaminated drinking water and fertilizer contamination from factory farms have recently come under increased scrutiny in states such as California, Minnesota and Michigan.
Iowa may be the canary in the coal mine.
Iowa Sen. Catelynn Doley stands on the state Senate floor during the March legislative session. She announced her cancer diagnosis here in January. Photo by Danny Wilcox Frazier
“Silence perpetuates bad systems”
Dre was elected in a special election following the death of state Sen. Rocky de Witt from pancreatic cancer in June 2025. Dre’s victory turned red seats blue and ended the Republican majority in the Iowa Senate.
“I am not lost on the irony that I was elected because my predecessor died of this terrible disease,” she said in her speech. “Ignoring the environment that Sen. de Witt and I shared is a disservice to voters. Silence perpetuates bad institutions.”
Dolly is a Dakota native (despite living in Iowa for 20 years, she says she sometimes receives skepticism from lifelong Iowans) and represents Iowa’s 1st Congressional District, which includes most of Sioux City.
Sioux City is located in the northwest corner of the state at the confluence of the Missouri and Big Sioux rivers. The town’s largest employers, other than the school district, are the Seaboard Triumph Foods pork processing plant and the Tyson beef processing plant, both located across the river in Nebraska.
Data compiled by the University of Iowa shows that Sioux City’s ZIP code 51106, just outside of Dory, has the highest rate of colorectal cancer in Iowa. More broadly, the highest age-adjusted colorectal cancer rates are concentrated in the northwestern corner of the state.
The northwest corner of Iowa is also known for its high concentration of factory farms. The correlation between factory farms and cancer rates is supported by a new Yale University study that found that counties near many factory farms in Iowa, Texas, and California had higher overall cancer rates.
Iowa State Sen. Catelynn Doley checks her cell phone inside the Iowa State Capitol on March 20, 2026. Photography: Danny Wilcox Frazier.
“I’m not interested in acting like this is just a personal medical issue. This is a public policy failure that’s happening to me,” Dolly told colleagues on the state Senate floor.
She told The Sentient that she has little in common with her predecessor, other than representing Iowa’s 1st District in the Iowa Senate. One is where they choose to live their lives. The other thing is that we were both diagnosed with cancer. While he doesn’t want to speculate on the exact cause of Iowa’s cancer crisis, he acknowledges there is something wrong in the state.
“We have an air quality issue,” Dray said. “We also have water quality issues across the state…We can’t ignore at this point that something in Iowa is driving the rise in cancer incidence and incidence.”
Iowa’s ‘toxic mixture’‘
A March 2026 report from the Iowa Environmental Council and the Harkin Institute describes Iowa’s “toxic mixture” problem. With 85% of its land being agricultural land, Iowa is disproportionately affected by pollutants such as fertilizers, pesticides and nitrates. The state’s bedrock and soil are naturally high in radon, a known carcinogen and the second leading cause of lung cancer in the United States. Radon gas can enter your home through cracks in your foundation.
“We know that something is going on population-wide in our region,” says Audrey Tran Lam, director of the environmental health program at the University of Northern Iowa’s Center for Energy and Environmental Education and one of the co-authors of the March report.
She explains how environmental and behavioral risk factors complicate determining causality, a persistent challenge with cumulative diseases like cancer. Although the exact cause of cancer may not be clear, preliminary evidence of harm may be enough to determine the need for change, she says.
“We know the extent to which these tendrils penetrate various aspects of people’s lives,” Tran Lam says of environmental risk factors, especially in “areas with a high concentration of food and agricultural activities.”
Cooperative Farmers Elevator feed mill in Ocheidan, Iowa. Ocheidan is located approximately 90 miles from the Dory area, also in the northwest quadrant of Iowa. Photo by Danny Wilcox Frazier
Iowa’s cancer crisis is a systemic problem and requires systemic solutions, Tran Lam said. “It’s not just that tweaking one aspect of the downstream product we’re facing might solve the problem. We really need to reevaluate what’s going on in this region and whether it’s really helping the people who live here.”
The health of Iowans depends in part on the health of the land, Tran Lam said. Her “fantasy” of what Iowa would be like includes diverse crops (often food for humans, not animals or cars) and safe places to recreate and swim underwater. This vision is what gets her out of bed in the morning.
“You can also get better health benefits by incorporating it,” she says. “That means people will be healthier.”
make others feel seen
Dolly’s first term in the Iowa Senate not only included a crash course in legislation, but also being a cancer patient and advocate. “When you tell people you have uterine cancer, you also have to tell your colleagues about it,” she says. “If it helps someone get the care they need or inspires someone to create better policies, then as far as I’m concerned, mission accomplished.”
She told Sentient that she was able to move quickly from her cancer diagnosis to a plan of action because she had the time and resources to advocate for herself within the health care system. In cancer, prompt diagnosis and treatment can mean the difference between life and death.
Iowa State Senator Catelynn Doley speaks with activists at the Iowa State Capitol on March 20, 2026. Photo by Danny Wilcox Frazier.
With this in mind, as a legislator, Dolly will focus on advocating for better access to screenings, diagnostic testing, and overall health care assistance for Iowans.
Weeks after Dray came forward with his story, Sen. Dave Lowery of Spirit Lake announced that he was undergoing treatment for tonsil cancer. On March 13, 2026, Indiana Sen. Julian Garrett announced his prostate cancer diagnosis, becoming the third Iowa senator in three months to announce a cancer diagnosis.
“We have this perception that once you’re elected, your job is just to get re-elected. That leads to secrecy and a lack of transparency around people’s health issues. And for me, I said from the beginning that this is another tool we can use to make people feel heard,” Dray says.
correction:
This article has been updated to report that Iowa County is west of Iowa City, not east.
Type of work:
news service Produced externally by organizations we trust to uphold journalistic standards.
