DES MOINES, Iowa—Water quality concerns have swelled into one of the most prominent issues shaping how Iowans across 99 counties will vote in the competitive races for governor and the U.S. Senate.
The issue burst into the Hawkeye State’s election cycle after a “Cancer in Iowa” report from the University of Iowa released in the spring ignited fears that nitrates in farm fertilizer runoff are getting into the water supply and contributing to the rise of cancer in the state.
“Our water is disgusting,” Democratic voter Maisie Stilwell said outside an early in-person polling location in Des Moines. “I don’t let my kids touch it. I certainly will not let them drink the tap water, and I know most other parents won’t either because you know it is full of disgusting chemicals and it’s just dangerous.”
A series of Iowans told The Epoch Times they paid for their own home reverse-osmosis systems because they don’t trust current leaders to have done enough to protect residents.
“It shouldn’t be on us, the consumers, to be solving this problem that is systemic in our state and that desperately needs to be addressed, because we also have such a cancer crisis as well,” Stilwell said.
The Study
In March, the Iowa Cancer Registry at the University of Iowa College of Public Health released its annual Cancer in Iowa report, causing a ripple effect across the state’s midterm campaigns.
The report predicted that 21,700 Iowans will be diagnosed with cancer in 2026—up over 30 percent from a decade ago. The findings added that the rate for young adult cancer diagnoses ranks the second highest in the country.
According to the report, the top five new cancer diagnoses are prostate, breast, lung, colon, and rectum cancer, and skin melanoma. Counties such as Polk, Linn, Scott, and Johnson are predicted to see the most new cases, reflecting their larger populations.
The report suggested drinking-water nitrate-nitrogen exposure at average levels above the federal limit was associated with an increased risk of prostate cancer and suggested a link with ovarian cancer but noted that more research was needed to understand how environmental exposures contributed to cancer risk.
Meanwhile, an analysis by University of Iowa researchers noted that smoking, drinking, obesity, and related behavioral factors explain about 76 percent of the extra cases of the five most common cancers that Iowa sees compared with the rest of the country.
They suggested a smaller share of cancer may be linked to environmental factors, including nitrates.
Water concerns sparked by the March report then escalated when the Central Iowa Water Works revealed in late July that the Nitrate Removal Facility ran for a record 193 days during the 2026 season.
Timothy Hagle, an associate professor in the Department of Political Science at the University of Iowa, suggested that the recent surge of news stories about Iowa’s water quality and rising cancer rates, along with limited access to health facilities in rural areas, has put the issue on every voter’s radar.
“Pretty much everybody in both parties is talking about healthcare, water quality, those sorts of things,” Hagle told The Epoch Times. “Now, the difference, of course, is going to be how they want to address this.”
The Candidates
In the governor’s race, Republican Zach Lahn and Iowa’s state auditor, Rob Sand, agreed during the Oct. 27 debate that nitrate levels in water are contributing to a surge in cancer rates.
Both want to support funding for the Iowa Water and Land Legacy program, back water quality monitoring, and give farmers incentives over government mandates, but they have different approaches to the solution.
Lahn, who has made the topic a defining campaign theme, asserts that nitrates are the primary driver of rising cancer and wants targeted funding focused on the most polluted waterways.
“The high nitrate load in water is one of the top causes of colon cancer, bladder cancer, ovarian cancer, and other types of cancer,” Lahn said during the final governor’s debate on Oct. 28. “I believe this is one of the biggest issues that we have not been looking at seriously.”
Lahn wants to expand Iowa’s water monitoring statewide, create targeted conservation incentives, and develop stackable, long-term incentives to fund saturated buffers, wetlands, and cover cropping to prevent contamination at the source.
The proposal resonated with Republican voter Brenan S., who came to see Lahn speak at a campaign event in Lyon County.
“The farming practices that he speaks about are very—I agree with him. We use some of those same farming practices,” he said.
But Democrats such as Stilwell say Sand would be better suited to fix the issue.
In debates, Sand cited the University of Iowa’s research, noting that nitrates aren’t the main cause of the cancer rise, but still urged action.
The Democrat wants to increase funding for aggressive water quality monitoring and farmer-led water quality programs, invest in radon testing, offer tax credits for farmers, establish a dirty water notification system, and create a Cancer Task Force.
In the Senate race, which The Cook Political Report ranked as a “Toss Up,” Republican Ashley Hinson and Democrat Josh Turek also take different approaches.
Hinson has called for infrastructure investments, water quality monitoring, and conservation programs, while Turek has said the state needs more funding for nitrate-removal infrastructure at treatment plants, incentives for farmers, and restored rural health care.
The Water
Drinking-water expert Rich “Raz” Razgaitis, the co-founder & CEO of FloWater, said Iowa has some of the most nitrate-polluted rivers in America and warned that even if the state is successful at getting levels below the legal limit, it doesn’t always mean it’s safe.
“The federal nitrate limit was set to protect infants from blue baby syndrome, not cancer,” Razgaitis told The Epoch Times, referring to a symptom of inadequate oxygenation in the blood.
Razgaitis urged people with reverse osmosis (RO) systems to not only keep their filters up to date but also use a system certified under NSF/ANSI 58 specifically for nitrate reduction.
“A neglected system keeps dispensing water long after it stops protecting you,” Razgaitis said. “Reverse osmosis is the seatbelt and airbags, not the road. It protects your family. It doesn’t fix the river.”
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