Iowa Medicine Q4 2025 Cancer in Iowa: A Public Health Emergency

JOURNAL OF THE IOWA MEDICAL SOCIETY WINTER 2025–2026

What to expect in the statehouse next session p. 8 American Medical Association 2025 Interim Meeting Report p. 16

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CONTENTS 5

PRESIDENT'S COLUMN

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ADVOCACY

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DONORS TO IOWA MEDICAL SOCIETY FOUNDATION

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DONORS TO IOWA MEDICAL POLITICAL ACTION COMMITTEE

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FROM THE UI DEAN

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TOP IMS 2025 ACCOMPLISHMENTS

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WELCOME JOSIE SYLTE

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I AM AN IMS MEMBER

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MEMBERSHIP

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2026 EDUCATION AND EVENTS

MISSION: To advance the practice of medicine through advocacy, education, and engagement with physicians throughout Iowa to ensure the highest quality of care for the patients they serve.

VISION: To be the leading voice in medicine to make Iowa a premier destination for physicians to live, work, and serve their communities.

CONTACT US: Iowa Medicine 515 E. Locust St., Ste. 400 Des Moines, IA 50309 Phone: 515.223.1401 PRESIDENT: Alison Lynch, MD CEO: Steven W. Churchill, MNA EXECUTIVE EDITORS: Sara Opie Josie Sylte ART DIRECTOR: Kelsey Wolfe TO ADVERTISE: Contact Heather Lee Phone: 515.421.4776 Email: hlee@iowamedical.org SUBSCRIPTIONS: Annual Subscription $45 IOWA MEDICINE, JOURNAL OF THE IOWA MEDICAL SOCIETY (ISSN 0746-8709), published quarterly by the Iowa Medical Society, 515 E. Locust St., Ste. 400, Des Moines, IA 50309 Periodicals postage paid at Des Moines, Iowa and at additional mailing offices.

FEATURES

POSTMASTER: Send address changes to Iowa Medicine, 515 E. Locust St., Ste. 400, Des Moines, IA 50309

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AMA HOD INTERIM MEETING

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CANCER IN IOWA: A PUBLIC HEALTH EMERGENCY

Editor's Note: A corrected version of the Marta Van Beek, MD, MPH, profile is available in the online edition of the Q3 Iowa Medicine magazine.

EDITORIAL CONTENT: The Iowa Medical Society is unable to assume responsibility for the accuracy of submitted material.

Editorial inquiries should be directed to the Executive Editor, Iowa Medicine, 515 E. Locust St., Ste. 400, Des Moines, IA 50309 Copyright 2025-2026 Iowa Medical Society: Opinions expressed by authors do not necessarily represent the official policy of the Iowa Medical Society. Iowa Medicine does not assume responsibility for those opinions. Products and services advertised in Iowa Medicine are neither endorsed nor guaranteed by the Iowa Medical Society unless specifically noted.

PRESIDENT'S COLUMN

WE ARE NOT DONE FIGHTING ALISON LYNCH, MD President, Iowa Medical Society

I

" magine a world without the physician voice.” These words were spoken by AMA President Bruce Scott, MD, last May at the Iowa Medical Society’s IMS 175th Anniversary celebration, as he called on us to unite and advocate for our profession and our patients.

Dr. Scott wasn’t trying to scare us, it was a call to action.

IMS is not only listening, but taking action. For the past six months, as IMS President, I have had the opportunity to meet with many of you—at IMS Blitzes, presentations, and social gatherings. I’ve heard from physicians and other health care personnel about staffing shortages, low reimbursement rates, the burden of prior authorizations, and other regulatory hassles, scope of practice concerns, and infractions on the patientphysician relationship. Over and over again the message is clear: the physician voice must be heard.

This fall, I met with Bevan Yueh, MD, MPH, inaugural chief physician executive at University of Iowa Health Care, to talk about the value of IMS membership and what it means to me. I got more involved with IMS because my patients had to wait a week before they could start a life-saving medication (buprenorphine), and when I reached out to IMS about it,

they advocated for a change in the law—and the law is now in place and saving lives! IMS membership matters because of advocacy.

Our members consistently tell us that advocacy is the number one reason they join.

More recently, IMS CEO Steve Churchill and I participated in several leadership panel discussions with rooms full of medical students from the Carver College of Medicine (with Iowa Health Care faculty member and AMA Board of Trustees member Marta Van Beek, MD, MPH) and at Des Moines University (with Dean of the College of Osteopathic Medicine David Connett, DO, and Associate Dean for Graduate Medical Education and Designated Institutional Official Jennifer Beaty, MD).

Medical students are our future, and engaging them early is critical. They are eager to learn about leadership, and look to IMS for leadership opportunities and mentorship.

IMS’ is to be the leading voice in medicine to make Iowa the premier destination for physicians to live, work, and serve their communities. While there is still work to do, we had some significant wins in the past year. For example, this summer Governor Reynolds signed a bipartisan bill to create 400 new residency positions, so more physicians can train in Iowa— this will help address the physician shortage, improving access for patients and reducing physician burnout. The legislature also doubled the amount of money in the rural healthcare loan repayment program and passed

prior authorization reform.

IMS successfully fought against a bill that would have criminalized mRNA vaccines. These wins wouldn’t have happened without IMS’ advocacy and leadership— IMS is fighting for us. But we are not done fighting.

IMS’ Operation I.O.W.A. II report issued this summer identifies multiple strategies to improve Iowa’s physician training pipeline, like fostering pre-med student exposure to mentorship and rural training opportunities. As you will read in Seth Brown's column in this issue, IMS continues to work hard to increase the Iowa physician reimbursement rate above the national 50th percentile. Your membership, whether you are an individual member or group member, supports these efforts and are why we are winning the fight.

Steve Churchill, Marta Van Beek, MD, and Alison Lynch, MD, speaking to University of Iowa medical students

Without our voice, decisions that impact our profession, our patients and our practices will be made by everyone else—the trial attorneys, administrators, insurance companies, and elected officials.

Our patients deserve better than that. A world without the physician voice in Iowa would be a world without IMS. If you want to make sure the physician’s voice is loud and clear, I hope you will renew your IMS membership today, or join us as a new member, so we can work together to advocate for our profession and our patients.

We need your membership now more than ever. ■

Alison Lynch, MD, David Connett, DO, and Jennifer Beaty, MD, speaking to Des Moines University students

IOWA MEDICINE WINTER 2025 –2026

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ADVOCACY

2026 LEGISLATIVE SESSION

WHAT TO EXPECT SETH BROWN, JD Director of Government Relations

The second year of the 91st he 2026 Iowa Legislative General Assembly brings both T Session begins Monday, opportunity and expected January 12, and the Iowa Medical

Iowa physicians gathered at the state Capitol on Physician Day on the Hill 2025

Society enters the year with strong momentum. Last session, lawmakers advanced several IMS priorities inspired by our Operation I.O.W.A. Phase I recommendations. The Legislature doubled rural physician loan repayment funds to $8 million, invested $150 million in new GME residency positions, enacted prior authorization reform, and stopped multiple bills that would have reduced patient access to immunizations.

challenges. Because carryover bills remain eligible, IMS expects to defend against vaccine-related proposals. Lawmakers also face an extremely tight state budget that could threaten long-overdue Medicaid reimbursement increases for physicians. Iowa projects a $75.9 million budget deficit for FY 2026 and a $180 million deficit for FY 2027.

Political dynamics are shifting, too, as Governor Reynolds’ decision not to seek re-election reshapes priorities and negotiations.

Still, IMS has many reasons for optimism.

New party and committee leaders in both chambers bring fresh energy.

IMS looks forward to

working closely with the new Majority Leaders, the new House Minority Leader, and the new Health and Human Services Committee Chairs in the House and Senate. Iowa’s application for up to $500 million over five years through the Rural Health Transformation Program also offers major opportunities. The proposal includes promising initiatives including physician workforce expansion, EMS and technology upgrades, and advances in cancer detection, prevention, and care. IMS expects lawmakers to introduce legislation this session that establishes the framework to implement these funds.

With so much in motion, grassroots advocacy will matter more than ever. Mark your calendars and register for Physician Day on the Hill on February 17. ■

Register for Physician Day on the Hill by scanning the QR code

REGISTER NOW IOWA MEDICAL SOCIETY’S

PHYSICIAN DAY ON THE HILL Tuesday, February 17, 2026 IMS Headquarters & First Floor Rotunda

8 IOWA MEDICINE WINTER 2025–2026

2026 STATE LEGISLATIVE PRIORITIES PRIORITIES ISSUE

DESCRIPTION The physician shortage in Iowa is in crisis. Iowa policymakers have made great strides combatting the shortage, but more can be done. To aid in the recruitment and retention of physicians, IMS supports:

EXPAND PHYSICIAN WORKFORCE

+ Increasing physician reimbursement rates to make Iowa a competitive practice environment. + Expanding access to and opportunities for rural medical student training. + Continued efforts to increase GME residency positions in Iowa. + Implementing tax credit and other incentives for preceptors and new physicians beginning their practice in Iowa.

OTHER CRITICAL ISSUES ISSUE

DESCRIPTION

REDUCE ADMINISTRATIVE BURDENS

IMS supports legislation that reduces burdensome administrative red tape in credentialing, CME, and beyond.

Physicians spend too much time wading through unnecessary administrative burden, contributing to burnout, instead of spending time with patients.

ENHANCE CANCER CARE

IMS recognizes the need for increased research to identify potential causes, preventative care, and treatments to address Iowa’s high cancer rate. IMS supports measures that enhance access to cancer testing, prevention, and care for Iowans.

PROTECT SCOPE OF PRACTICE

IMS champions the practice of medicine that recognizes medical training and expertise in scope allowances, stopping any proposed expansions that threaten patient safety.

ENSURE PROPER AI USE IN HEALTH CARE

IMS encourages the study of artificial intelligence (AI) use in health care to optimize patient care and improve outcomes throughout the health care process.

IOWA MEDICINE WINTER 2025 –2026

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DONOR REPORT

THANK YOU

The mission of the Iowa Medical Society Foundation (IMSF) is to advance the work of the Iowa Medical Society through education and leadership opportunities for current and future physicians in Iowa.

Your generous contributions allow us to make a lasting impact in Iowa and globally to: + Help fund Global Health Clinical Experiences + Purchase white coats for medical students in Iowa + Provide opportunities for medical students to attend AMA events + Offer scholarships for medical student experiences + Fund student leadership development programs The following individuals donated to IMSF as of Dec. 15, 2025. Thank you!

$25,000 AND ABOVE Char Henry Albert Trust Fund $2,000 AND ABOVE Steven W. Churchill, MNA Marygrace Elson, MD Alison Lynch, MD

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$1,000 AND ABOVE Paul Mulhausen, MD Noreen O'Shea, DO and Tom Benzoni, DO Siroos Shirazi, MD Marta Van Beek, MD Keith Vollstedt, MD Humphrey Wong, MD

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$500 AND ABOVE Robert Bartelt, MD Cynthia Hoque, DO Rachel Preisser, MD Joel Ryon, MD Christina Taylor, MD

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$250 AND ABOVE William Ching, MD Kevin Cunningham, MD Lillian Erdahl, MD Thomas Evans, MD Lenard Kerr, DO William McMillan, MD Harold Miller, MD Daniel McCabe, MD Douglas Peters, MD Peter Tonui, MD Fadi Yacoub, MD

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If you are interested in giving to IMSF in 2026, scan the code!

◆ IMS Board Member

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10 IOWA MEDICINE WINTER 2025–2026

$100 AND ABOVE Mary Ann and Michael Abrams Candyce Ackland, MD Jeffrey Anderson, MD Steve Ayala Jason Deutmeyer, MD Michael Flesher Jerome Greenfield, MD Kenneth Hartman, MD Seema Harichand-Herdt, MD James Hubbard, MD Kimberly Kenne, MD Mary and Michael Kitchell, MD Becky and Timothy Kresowik, MD Heather Lee Shannon Leveridge, MD Barcey Levy, MD Rebecca Lundquist, MD Congresswoman Mariannette Miller-Meeks, MD Brian Privett, MD Victoria Sharp, MD Bryan Steussy, MD Hanna Stevens, MD Maria Story, MD Joysree Subramanian, MD Josie Sylte Bruce Trimble, MD Michelle Weckmann, MD Jessica Zuzga-Reed, DO

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$50 AND ABOVE Emily Boevers, MD Mikayla Brockmeyer, DO Seth Brown, JD Grace Fleming Erin Hayward, MD Fabian Li Adetayo Oladele-Ajose, MD Sara Opie

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BELOW $50 Jessica Duffy, OMS-III Brian Heineman, DO Daniel Moe, M4 Petra Stout Mara Syring, DO Kelsey Wolfe Judson Wood Houses into Homes

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Money donated to IMSF helps support the current and future physicians of Iowa

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DONOR REPORT

THANK YOU IMS serves as your voice for advocacy. Your generous contributions allow us to build strong relationships with policymakers and protect the interests of our physician members and the broader medical community. This list reflects gifts to the Iowa Medical Political Action Committee (IMPAC) in 2025 received as of Dec. 15.

Thank you to the following donors for their contributions which help amplify the voice of Iowa physicians!

TITANIUM ($10,000 AND ABOVE) Iowa Medical Leadership PAC PLATINUM ($5,000 AND ABOVE) Jon Van Der Veer, DO GOLD ($2,500 AND ABOVE) Steven W. Churchill, MNA Marygrace Elson, MD Shiny Mathewkutty, MD Kaaren Olesen, DO Keith Vollstedt, MD

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SILVER ($1,000 AND ABOVE) Robert Bartelt, MD Kevin Cunningham, MD Tom Evans, MD Alison Lynch, MD Daniel McCabe, MD Michael McCoy, MD Doug Peters, MD Rachel Preisser, MD Brian Privett, MD Sharmini Rasakulasuriar, MD Joel Ryon, MD Victoria Sharp, MD Christina Taylor, MD Peter Tonui, MD

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Marta Van Beek, MD Humphrey Wong, MD Fadi Yacoub, MD Clete Younger, MD

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BRONZE ($500 AND ABOVE) Tom Benzoni, DO Seth Brown, JD Terence Cullen, DO Lillian Erdahl, MD Jonathon Geisinger, MD Lindsey Jenkins, MD Doug Martin, MD Joseph Merchant, MD Noreen O’Shea, DO Steven Richards, DO Dawn Schissel, MD

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BELOW $100 Josi Barscz, OMS-IV Heather Lee Daniel Moe, M4 Adrienne Nguyen, OMS-IV Adetayo Oladele-Ajose, MD Brooke Turek, DO Joshua Turek, DO Katherine Yu, M2

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If you are interested in giving to the 2026 effort for IMPAC, scan the code

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FRIEND OF MEDICINE ($250 AND ABOVE) William Ching, MD Timothy Dettmer, MD Abby Mancuso, MD Rene Recinos, MD Yogesh Shah, MD Ben Vallier, MBA Ed Whitver Cynthia Wong, MD BELOW $250 Erin Shriver, MD Mara Syring, DO Kate Walton Jessica Zuzga-Reed, DO

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IMPAC raised $60,000 in 2025 $60,000

$50,000

$40,000

$30,000

$20,000

$10,000

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◆ IMS Board Member IOWA MEDICINE WINTER 2025 –2026

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Testing is the gateway to HIV prevention & treatment— and you hold the key.

Health care providers are essential to ending the HIV epidemic in Iowa. The best first step you can take?

Offering routine HIV screening as part of your practice.

Diagnosing HIV quickly and linking people to treatment immediately are crucial to reducing HIV transmissions and improving health outcomes for all.

Testing for HIV empowers patients, no matter their status. For people living with HIV, diagnosis is the first step in connecting to HIV resources and care. For people who do not have HIV, testing can begin an ongoing conversation about their prevention needs.

Scan our QR code to learn more or visit stophiviowa.org/providers

DEAN’S ARTICLE

THE PATH FORWARD IN CANCER CARE DENISE JAMIESON, MD, MPH University of Iowa Vice President for Medical Affairs and the Tyrone D. Artz Dean, Carver College of Medicine

am so proud to be a part of For nearly 25 years, Holden ICare’s University of Iowa Health has been Iowa’s only National mission to serve our fellow Cancer Institute-designated Iowans across the entire state.

Every year, we care for more than a million patients at our medical campuses and clinics; our research drives breakthroughs in clinical care; and we train nearly half of Iowa physicians.

Our mission has never been more important than right now, especially as we consider Iowa’s cancer rates.

Cancer has likely touched all our lives in some way—whether we know a family member, friend, or loved one who has battled cancer, or even experienced it firsthand.

According to the latest Iowa Cancer Registry report, more than 1 in 20 people in Iowa have had a diagnosis of cancer at some point in their lives.

Those are daunting numbers, but there’s also good news.

Patients with cancer in Iowa also have a better chance of survival compared to those in other states.

Though Iowa has one of the highest incidences of cancer in the nation (#2), our rates of mortality are much lower (#24).

And we have a team of experts at Holden Comprehensive Cancer Center working every day toward one common goal: defeat cancer.

A SHARED MISSION Every year, we understand more and more about cancer in Iowa, and having the tools that can tackle the complexity of the disease starts with expertise.

comprehensive cancer center, a distinction held by fewer than 5% of centers nationwide. We have more than 150 cancer experts and specialized teams studying the most common cancers in Iowa, informing new cancer treatments, and delivering that care directly to patients.

As an academic health care system in a rural state, we also understand how critical it is for patients statewide to have access to early interventions and the latest treatments. That’s why we’re leading a statewide effort to fight cancer in Iowa.

IMPROVING ACCESS TO CARE THROUGH A STATEWIDE CANCER CARE NETWORK We know the solution requires better statewide collaboration and pooling our resources.

In January 2025, we announced that Mission Cancer + Blood would officially become part of UI Health Care, paving the way for a statewide comprehensive cancer care network.

Mission has more than 20 community cancer clinics across Iowa that are now backed by our comprehensive cancer center.

In less than a year, we have started laying out the foundation for a network of care aimed at keeping high-quality cancer care local for Iowans.

And the power of sharing resources, expertise, and access to important research tools to advance cancer care is beginning

to take shape as the first set of joint clinical trials has launched at UI Health Care and Mission locations.

Pediatric CT scan Image provided

by University of Iowa Health Care

We also recently expanded access to tumor boards and grand rounds for doctors across Iowa. Cancer care is changing rapidly, and having resources that allow cancer experts to tap into collective knowledge is critical to improving outcomes in Iowa.

A SHARED PATH FORWARD Continued research, innovation, and collaboration with statewide partners will continue to be an important part of our strategy as we expand access to expert care and solutions.

I’m incredibly proud of our team for coming up with brave and creative solutions for our state because we know that a breakthrough treatment for a patient can mean not only more years, but better years.■

IOWA MEDICINE WINTER 2025 –2026

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2025 YEAR IN REVIEW

TO P I M S ACCO M PLIS H M E N T S O F 2 025 passage of Governor’s Rural Health Bill:

$150 million

$60,000

for 460 new residency spots

raised for IMPAC

and

health care leaders who attended the Rural Healthcare Workforce Summit:

72

for physician loan repayment

345% website visits

increase in

banner year launched

$64,000 raised for IMSF

Operation

I.O.W.A.

Legacy Society

139%

FIVE Physicians to Watch

Award

th anniversary celebration

with ~

increase in event attendance

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creation of

2.0

175 1850

creation of the IMSF

$8 million

200 attendees approval of bill to streamline

HF

303

prior authorization

Actionable Insights

Copic is the preferred, endorsed medical professional liability insurance provider for IMS members.

IMS' delegation to the AMA at the Interim meeting in National Harbor, Maryland

AMA HOD 2025 INTERIM MEETING REPORT VICTORIA SHARP, MD, MBA Chair, Iowa Delegation, AMA HOD

ith heartfelt gratitude, I W share my final American Medical Association (AMA)

House of Delegates (HOD) report as I wrap up my time as Iowa Medical Society (IMS) Delegation Chair. Serving alongside dedicated colleagues in the delegation for over a decade has truly been an honor. I’m deeply proud of what we’ve achieved together, and I’m excited to watch the Iowa delegation continue to lead with passion and purpose.

16 IOWA MEDICINE WINTER 2025–2026

At the recent Interim AMA HOD meeting in National Harbor, MD (Nov14-18, 2025), nearly 700 physicians, residents, and medical students gathered to address significant issues central to our profession and the health of our communities.

Our delegation, in collaboration with the North Central Medical Conference, participated in six reference committees: Ethics

and Bylaws, Legislation, Medical Education, AMA Governance and Finance, Medical Practice, and Science and Public Health.

Testimony was informed by subject matter expertise, current health policy research, and the perspectives of state medical associations and national specialty societies. Over 150 reports and resolutions were considered.

Highlights of the meeting included the rallying cry of the AMA, “Fighting for Physicians.” Detailed reference committee testimony, thoughtful HOD debate and votes led to new and updated AMA policies and direction for the AMA Board of Directors and staff. A few of these are underscored below and additional details can be found on AMA HOD’s interim meeting website. + New policy to create and share model AI learning objectives and curricular toolkits aligned with its guidelines for trustworthy AI in medicine. The goal is to expand AI education and training for medical students, residents, fellows, and physicians through comprehensive learning and CME resources, promoting the responsible and ethical use of AI in health care practice.

+ Policy to urge federal and state governments to provide stable, equitable funding for school-based mental health services, giving priority to rural and underserved communities after over $1 billion in mental health grants were rescinded by the U.S. Department of Education earlier this year. They also called for federal legislation to include automatic continuity measures, like bridge funding, to prevent disruptions in student mental health services and workforce stability when appropriations are delayed or withdrawn.

Our delegation stayed an extra day to visit our Iowa’s federal legislators and their staff on Capitol Hill to discuss issues such as, Medicare physician payment reimbursement, CMS approval of GME Residency training slot funds, and Doctors Act/ J1 Visas to reallocate unused Conrad 30 waivers of foreign residency requirements to states, such as Iowa, to help address physician shortages in underserved areas.

IOWA

+ New policy that directs the AMA to advocate that all health care systems systematically identify veteran patients, document their service history and exposures, and track quality and safety outcomes by veteran status.

It calls for veteran-focused education and training across undergraduate, graduate, and CME, as well as licensure requirements, to strengthen workforce preparedness. It further seeks collaboration with Veteran Service Organizations, specialty societies, and public health agencies to create and promote evidencebased clinical guidelines, and to embed veteran health considerations in all health equity, community health assessment, and population health frameworks.

Medical students from University of Iowa and Des Moines University attended the AMA Interim meeting with some funding coming from the Iowa Medical Society Foundation

DELEGATION DELEGATES Victoria Sharp, MD, Chair Tom Evans, MD Doug Martin, MD Doug Peters, MD

ALTERNATE DELEGATES Brian Privett, MD Cynthia Hoque, DO Alison Lynch, MD, IMS President

OTHER ATTENDEES Steve Churchill, IMS EVP & CEO Marygrace Elson, MD, Past IMS President Marta Van Beek, MD, AMA Board of Trustees Member Andrea Greiner, MD Shane Hopkins, MD Hillary JohnsonJahangir, MD Erin Shriver, MD Megan Srinivas, MD Several engaged medical students from the University of Iowa Carver College of Medicine and Des Moines University.

The AMA HOD will convene for the 2026 annual meeting in Chicago June 5-10. The Interim meeting in Orlando, Fla. will be Nov. 6-10. ■

The delegation stayed in Washington D.C. to talk to Iowa legislators on Capitol Hill

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A PUBLIC HEALTH EMERGENCY JOSIE SYLTE Director of Communications and Marketing

y mom died of breast cancer M that progressed to bone metastases when I was 24. This

year, my brother-in-law was diagnosed with stage IV prostate cancer, and my best friend had a double mastectomy after being diagnosed not once, but twice, with breast cancer. Chances are your experience as an Iowan is similar. Cancer in Iowa is horribly personal and far too common; it’s become a critical public health challenge for our state According to recent data from the Iowa Cancer Registry, Iowa has the second-highest, ageadjusted rate of new cancer cases in the United States, behind only

Iowa is one of only two states in the nation where overall cancer rates continue to rise. Utah, which has one of the lowest rates, is the other.

For physicians practicing in Iowa, these statistics are not abstract— they reflect the patients they see every day in clinics and hospitals across the state.

“This is a public health emergency that has been hiding silently in plain sight,” says Sharmini Rasakulasuriar MD, (Dr. Suriar) Internal Medicine, Fort Dodge and 2026 IMS delegate to the RATE OF NEW CANCERS AMA. “Cancer isn’t being talked about as much as it should IOWA be. At every visit, clinicians should dedicate more time to meaningful conversations UNITED about improving STATES lifestyle habits and reducing avoidable chemical exposure.”

520

AGE-ADJUSTED CANCER INCIDENCE RATE

Kentucky. Iowa’s rate is 14% higher than the national rate. Prostate, breast, lung, and melanoma cancers are the biggest contributors pulling Iowa away from national trends.

500

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400 2000

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Data provided by the Iowa Cancer Registry

UNDERSTANDING THE DRIVERS BEHIND IOWA’S RISING CANCER RATE Iowa’s rising cancer rates reflect a complex mix of risk factors—some seen nationwide and others more distinctive to our state. Alongside well-known lifestyle contributors such as tobacco use, alcohol consumption, obesity, nutrition, and insufficient physical activity, Iowa faces elevated risks tied to its geology, agricultural landscape, and rural demographics.

Radon levels are among the highest in the country, with all 99 Iowa counties falling in the EPA’s highest-risk zone. Radon exposure combined with tobacco use increases lung cancer risk by 10 to 20 times. Many Iowans rely on private wells susceptible to nitrate contamination. Farm-related exposures—including pesticides, herbicides, and extended UV exposure—add layers of concern.

contributing to rising rates.

According to State Medical Director Robert Kruse, MD, MPH, the effort focuses on identifying which environmental, behavioral, and health-system factors are contributing most to Iowa’s elevated cancer burden— and which of those factors are most actionable for prevention, investment, and policy change.

The Iowa Cancer Consortium, a statewide coalition supporting cancer prevention and control, connects partners across the state and offers the Iowa Cancer Plan, a free, evidence-based road map for improving prevention, screening, treatment, and survivorship.

At the same time, the Iowa Cancer Registry’s 99 Counties Project is delivering county-specific cancer profiles and hosting local meetings to help communities understand their unique burden and risk landscape. Together, these initiatives aim to fill longstanding data gaps while giving physicians and local - Sharmini Rasakulasuriar, MD leaders a clearer picture of where At the same time, gaps in cancer incidence is highest and screening, vaccination rates, and what interventions may be most access to specialty care continue effective going forward. to widen rural-urban disparities.

These overlapping factors have LUNG CANCER: THE prompted an urgent push to better CANCER IOWA CANNOT understand why Iowa’s cancer AFFORD TO IGNORE trends differ from neighboring Mary Charlton, states and what is driving these PhD, Director patterns at the county and of the Iowa community level.

Cancer Registry WHAT IOWA IS at the University of Iowa College DOING TO RESEARCH of Public Health, THESE FACTORS reminds physicians that Iowa’s Iowa has begun investing in elevated cancer rates cannot be deeper exploration to pinpoint traced to any single factor. what is driving the state’s high “There is not ONE thing causing cancer incidence. The Cancer cancer in Iowa,” she emphasizes.

Drivers in Iowa Project, created “But one of the strongest risk through state legislation factors is smoking.” enacted in 2025, brings together According to data from the Iowa University of Iowa researchers Cancer Registry’s Cancer in Iowa and Iowa Health and Human report, lung cancer remains the Services staff to analyze deadliest cancer in the state, with environmental exposures, an estimated 2,560 new cases and screening patterns, demographic 1,430 deaths in 2025 (23% of all factors, and geographic variations

“This is a public health emergency that has been hiding silently in plain sight.”

cancer deaths), and a five-year survival rate of just 27.1%. Iowa ranks 12th nationally for new lung cancer cases and 18th for lung cancer deaths.

“Physicians are getting more questions than ever about cancer—patients want to know exactly what they should be doing to stay ahead of it.”

- Joe Merchant, MD

Kelly Wells Sittig, Executive Director of the Iowa Cancer Consortium, notes that Iowa’s overall cancer screening rates are largely in line with national averages, emphasizing that screening alone cannot explain the elevated incidence.

With that being said, screening is an important component for Iowans. From the clinical frontlines, Joe Merchant, MD, Oncologist at McFarland Clinic in Ames, stresses the importance of making screening routine and accessible. “Physicians are getting more questions than ever about cancer—patients want to know exactly what they should be doing to stay ahead of it. The fundamentals still matter most: mammograms, colonoscopies, Pap smears, paying attention to skin changes in chronically sunexposed workers, and making sure high-risk patients get a CT scan for lung cancer. Since Iowa is among the worst in the nation for lung-cancer outcomes, we should be doing a lot better with lung-cancer screening.”

Sharmini Rasakulasuriar MD, Internal Medicine, Fort Dodge with a patient

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Pornchai Jonglertham, MD, Hematologist/ Oncologist with Nebraska Cancer Specialists

Dr. Suriar underscores that prevention counseling must extend beyond traditional screening conversations to include clear education about environmental risks— particularly radon. “We have a responsibility to actively educate our patients— especially about preventable risks like radon exposure and its well-established link to lung cancer,” she stated.

IOWA HHS

CANCER DRIVERS IN IOWA Iowa Health and Human Services continues to advance the Cancer Drivers in Iowa Project in close collaboration with the University of Iowa College of Public Health. The work is progressing, and more detailed updates are expected in the coming months.

Overview of Cancer Drivers in Iowa Project

The focus is to understand why Iowa continues to have some of the highest cancer incidence rates in the country. The goals include: + Identifying the environmental, behavioral, and health-system factors contributing to Iowa’s elevated cancer burden. + Determining which of these factors are the most actionable. + Using the findings to guide statewide prevention, policy, and investment strategies.

Areas of Focus

The project team is currently analyzing several priority domains: 1. Environmental exposures—evaluating geographic patterns of cancer alongside environmental exposures.

2. Behavioral and lifestyle factors—including smoking, obesity, alcohol use, and other modifiable risks.

3. Screening and early detection—assessing gaps in screening access and uptake.

Next Steps

+ Continued deep-dive modeling using linked environmental, behavioral, and healthcare datasets. + Refinement of geographic “hot spot” analyses. + Development of a statewide findings report. + Planning for longer-term prevention efforts focused on modifiable risks and improved screening based on findings.

Source: Robert Kruse, MD, MPH, State Medical Director and Director, Division of Public Health

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For Pornchai Jonglertham, “PJ”, MD, Hematologist/ Oncologist with Nebraska Cancer Specialists in Council Bluffs, the challenges are even sharper in the western and rural parts of the state. He notes, “Lung cancer is especially high in our region, and rural realities delay diagnosis. Many patients travel 60 to 150 miles for oncology care, while socioeconomic barriers and limited imaging capacity can slow both screening and followup.” Also, workforce shortages leave smaller towns without specialists, contributing to later-stage diagnoses.

Collectively, these perspectives highlight why lung cancer stands apart—not only because it kills more Iowans than any other cancer, but because it is the cancer for which the clearest evidencebased interventions already exist.

WHAT PHYSICIANS SHOULD KNOW ABOUT IOWA’S CANCERRELATED POLICIES Seema Harichand, MD, Hematologist/Oncologist, Mission Cancer + Blood, part of University of Iowa Health Care, says the top things physicians can do to improve the cancer issue in Iowa are simple but important, "We need to take more time to talk with our patients about the prevention of cancer through lifestyle modifications and screenings. People are more open and responsive if they feel that you care.”

She adds that getting involved to influence policy is critical, too.

“Another thing we can do is to make an effort to get in front of our legislators and influence policy that can have a positive impact on Iowans.

I’d love to personally get more involved in legislation.”

At the policy level, Iowa is beginning to assemble a more coordinated response to its rising cancer burden. The state has applied for $500 million in

funding over five years through the Rural Health Transformation Program (RHTP), part of the federal H.R. 1 or One Big Beautiful Bill Act—a significant future opportunity to bring much-needed resources into rural communities. If awarded, these funds would support expanded screening capacity, upgraded diagnostic equipment, enhanced oncology navigation, radon mitigation efforts, and the development of rural Cancer Health Hubs. Iowa Medical Society (IMS) looks forward to partnering with the state- issued RFPs to guide implementation and ensure physician voices shape how these dollars are deployed.

Alongside RHTP, several cancer-related laws enacted last legislative session are now moving into implementation.

Meanwhile, the state’s Get Screened Colorectal Cancer Program continues to expand access to Fecal Immunochemical Tests and colonoscopies for underserved Iowans, and its Care For Yourself program provides mammograms, clinical breast exams, pelvic exams, Pap tests, and HPV tests for women who qualify. Together, these initiatives —paired with the proposed RHTP investment—provide physicians with new tools, stronger patient protections, and a clearer framework for improving early detection and cancer outcomes statewide.

Looking forward, enhancing cancer care is one of the IMS 2026 Legislative Priorities.

Seema Harichand, MD, Hematologist/Oncologist, Mission Cancer + Blood

INNOVATIONS IN TREATMENT AND THE STRENGTH OF IOWA’S ONCOLOGY NETWORK Frédérique St-Pierre, MD, Hematologist/ Oncologist at Great River Health in West Burlington, sees firsthand how rapidly cancer care continues to evolve. Community oncology programs across Iowa now offer the same FDA-approved therapies, immunotherapies, and targeted treatments as major academic centers. When a case requires more specialized evaluation, Iowa’s strong statewide partnership with the University of Iowa Heath Care Holden Comprehensive Cancer Center ensures seamless referral and co-management. “We stay up to date with novel therapies,” Dr. St-Pierre explains, “and when a case requires a more specialized approach, we have the University of Iowa to refer to.”

This connectivity ensures that patients in rural and semirural communities do not face a lower standard of care simply because of geography.

STRENGTHENING SURVIVORSHIP CARE ACROSS URBAN AND RURAL IOWA While Iowa’s cancer incidence remains higher than much of the country, patients with cancer in Iowa have a better chance of survival compared with those in many other states. Iowa ranks 24th in cancer mortality—a rate far lower than its incidence would predict—reflecting strong treatment networks, timely interventions, and advances in care across the state.

Sneha Phadke, DO, MPH, Medical Oncologist and Director of Cancer Survivorship at the University of Iowa Health Care Holden Comprehensive

Cancer Center, emphasizes that the cancer journey does not end when treatment does. Iowa now has nearly 172,000 cancer survivors, representing over 5% of the population, many of whom face long-term physical, emotional, and financial impacts. “We’re learning that patients don’t simply return to their old lives after treatment,” Dr. Phadke says. “Survivorship brings its own set of needs, and we want to partner closely with primary care so patients don’t fall through the cracks at this stage of their journey.”

Rural survivors often encounter additional challenges: shortages of primary care providers, limited access to rehabilitation and mental health services, and greater travel distances for specialized follow-up. Dr. Phadke and her team are developing a dedicated survivorship clinic—planned for early 2027—to streamline communication with primary care providers, provide navigation support, and offer specialized expertise in managing late effects and quality-of-life concerns.

THE FINANCIAL IMPACT ON PATIENTS AND IOWA’S HEALTH SYSTEM Iowa’s high cancer incidence has implications far beyond clinical outcomes. It also places growing pressure on insurance premiums and out-of-pocket costs for patients. As more Iowans require complex, prolonged or specialty cancer care, employers, health plans, and families are experiencing rising financial strain. Cancer now represents one of the top drivers of health care spending in the state, affecting both fully insured and selffunded populations. As Nataliya Boychenko Stone, Ph.D., Senior Vice President and Iowa Market Leader of Employee Benefits at Holmes Murphy, explains, “Cancer continues to be a top condition driving Iowa’s health care costs.

In our HMA Book of Business 2024 data, at least 1 in 10 members 18 and older experienced a cancer episode during the year, and costs increased almost 5% from the previous year.”

She notes that these rising costs make it even more imperative for physicians and communities to work together to support early detection, patient education, and increased access to screening—the interventions most likely to reduce both the human and financial burden of cancer in Iowa.

CONCLUSION: A COMPLEX CHALLENGE— AND A LONG GAME THAT REQUIRES PHYSICIAN LEADERSHIP Iowa’s cancer burden is not the result of a single exposure, behavior, or demographic trend, but a convergence of environmental, lifestyle, occupational, geographic, and systemic forces. “Cancer in Iowa is a long-term and complex issue.

“Cancer continues to be a top condition driving Iowa’s health care costs.”

- Nataliya Boychenko Stone, Ph.D. The trends we’re seeing today took years—maybe decades—to develop. Similarly, we won’t see results from the changes we make today for years down the road,” says Sittig, of the Iowa Cancer Consortium. This underscores why sustained prevention, screening, data transparency, policy change, and clinical leadership must move forward together.

Physicians who practice in Iowa understand this complexity better than most. Dr. Suriar urges clinicians across the state not to wait for others to lead, “We really need to step up. Physicians have to look hard at what’s going on with cancer in Iowa. We can’t sit back and let others take care of it.”

Dr. Harichand says now that the increased rates of cancer have been identified, we have the opportunity to make a difference, “Armed with this information, we can start working on better understanding the core issues and crafting solutions. There is hope for a brighter, healthier future for Iowa.” ■

CANCER IN IOWA RESOURCE GUIDE

For a comprehensive Cancer in Iowa Resource Guide for Physicians, including link to an update on The Cancer Drivers in Iowa Project and the Iowa Cancer Plan, please visit our website: iowamedical.org/ cancer-resources

Would you like to provide feedback on this article? Email jsylte@iowamedical.org

IOWA MEDICINE WINTER 2025 –2026

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JOSIE SYLTE Director of Communications and Marketing

t is a privilege to introduce ICommunications myself as the new Director of and Marketing for the Iowa Medical Society and the incoming Editor of Iowa Medicine. I have held leadership positions in marketing and communications for decades in the finance, entrepreneurial and technology sectors.

I am truly grateful for the opportunity to support an organization and publication with such a trusted history of elevating physician voices and strengthening the practice of medicine across our state. I also want to extend heartfelt appreciation to Sara Opie as she begins her muchdeserved retirement. She set a high standard for how IMS shows up.

I’m thankful for the foundation she built and honored to continue the work she championed.

Effective communication make an impact that strengthens is more than a task—it’s a the future of medicine in Iowa. performance driver. Research As I begin this role, I welcome shows organizations with strong your ideas for how Iowa communication practices are 3.5 Medicine and IMS can times more likely to outperform continue to evolve. I also invite their peers*. When people members to submit op-eds for understand the mission and consideration in Iowa Medicine. feel a part of it, engagement rises and results follow. In a + What current topics would you find valuable to see statewide medical community expanded or covered more often? as dedicated and diverse as ours, communication means + What formats help you receive value quickly? connection, alignment, and collective strength. + How do you like to receive information and news?

My goal is simple: deliver content Reach out to me directly at that advocates for you, educates jsylte@iowamedical.org with clarity, and engages in ways that strengthen our collective Together we can build on a strong voice. Your physician experiences, legacy. It is an honor to serve you insights, and needs should guide in the work ahead. ■ the conversations we elevate. I *Source: Change & Communication study look forward to learning from our by Towers Watson members and working together to

Nominate your colleagues for an IMS award! + Five Iowa Physicians to Watch + IMS/Copic Physician Humanitarian Award + Merit Award + John F. Sanford Award + Washington Freeman Peck Award

Each year, IMS recognizes physicians, nonphysicians, and organizations who have provided outstanding contributions to IMS, the profession of medicine, or public health by presenting the awards above.

Recognize your friends and colleagues by nominating them today! Scan the QR code to learn more about each of the awards and to submit your nomination.

2026 NOW ACCEPTING SUBMISSIONS FOR 2026 FIVE PHYSICIANS TO WATCH Created in 2025 for the 175 year anniversary of the Iowa Medical Society, the “Five Iowa Physicians to Watch" award recognizes five outstanding Iowa physicians nominated by their peers.

Award recipients will be recognized at the 2026 President's Dinner Scan the QR code and fill out the nomination form to recognize your colleagues and the work they do for their patients.

WELCOME JOSIE!

A MESSAGE FROM YOUR NEW DIRECTOR OF COMMUNICATIONS & MARKETING

I AM AN IMS MEMBER

ALYSSA RAY, MD

Internal Medicine Primary Care MercyCare, Cedar Rapids WHAT INSPIRED YOU TO BECOME A PHYSICIAN?

WHY ARE YOU A MEMBER OF IMS?

WHAT IS YOUR BEST ADVICE FOR NEW PHYSICIANS?

medicine for 35 years. I saw firsthand an excellent example of an accessible, thoughtful, and caring doctor in my father.

Throughout medical school and residency, I watched internists expertly diagnose and treat patients by integrating every piece of clinical context into their decision-making.

doctors, and I want my patients to see the best physicians in the country right here in Iowa.

advice originated from Dr. Osler, who is considered a founder of internal medicine: “Listen to

was inspired to go into medicine I joined the Iowa Medical Society I am a new physician, myself so I Ipracticed originally by my father, who because I want my patients to hesitate to give advice to others. general internal have improved accessibility to One of my favorite pieces of

HOW DID YOU END UP IN YOUR CURRENT CAPACITY?

I AM AN IMS FOUNDING MEMBER

I started practicing medicine this year after graduating residency at the University of Iowa.

I WANT MY PATIENTS TO SEE THE BEST PHYSICIANS IN THE COUNTRY RIGHT HERE IN IOWA. WHY SHOULD MORE DOCTORS COME TO IOWA TO PRACTICE?

I love practicing in Iowa because of my patients and colleagues who I work with every day. The sense of community and commitment to patient care is very special.

your patient; he is telling you the diagnosis.” That quote shapes my approach to every encounter. ■

DAVID McGUGIN, MD (1807-1865) EARLY LIFE

D

r. McGugin was the second president of the Iowa Medical Society, elected to the position at the Fairfield, Iowa, Session on May 5, 1852.

Born in West Middleton, Pennsylvania, Dr. McGugin studied medicine under Dr. Andrews of Steubenville, Ohio. He graduated from the medical department of the University of Maryland and began the practice of medicine in western Pennsylvania.

Dr. McGugin served as a surgeon in the Army and following his service moved to Keokuk, Iowa. He was selected as professor of physiology, pathology, and microscopy, continuing in

24 IOWA MEDICINE WINTER 2025–2026

this position and as president of the faculty at State University in Keokuk.

PUBLIC SERVICE

Active within IMS, Dr. McGugin was one of the first editors of the Iowa Medical Journal. He also served on the board of directors of the State Hospital for the Insane at Mount Pleasant when it opened in 1861 and was president of the Board of Health in Keokuk for several years.

When the Civil War broke out, Dr. McGugin was appointed surgeon of the Third Iowa Cavalry. After the Battle of Pea Ridge, he resigned because of failing health and returned to Keokuk. He later assumed charge of the Leighton House Hospital until his death in 1865.

LEADING AND TEACHING

This founding IMS member was a leading physician in Keokuk and considered an excellent teacher who added distinction to the young medical school and IMS. ■

MEMBERSHIP

THE POWER OF MEMBERSHIP WHY PHYSICIANS ACROSS IOWA ARE STRENGTHENING THEIR PROFESSION THROUGH IMS MEMBERSHIP

HEATHER LEE Director of Membership and Sponsorship

cross Iowa, from A independent clinics to large health systems, one constant continues to prove its value for physicians: membership in the Iowa Medical Society (IMS).

and practice sizes. Members fuel IMS’ presence and influence, and that support drives advocacy wins such as defending physicianled care and securing funds to expand residency slots.

WHEN IMS SPEAKS, POLICYMAKERS KNOW WE REPRESENT THOUSANDS OF PHYSICIANS AND FUTURE PHYSICIANS ACROSS SPECIALTIES AND PRACTICE SIZES. For more than 175 years, IMS has served as the unified voice of Iowa physicians, advocating for better care environments and physician well-being. Today, membership is more than a dues payment. It is an investment in a stronger medical profession and a healthier Iowa.

ADVOCACY THAT PROTECTS YOUR ABILITY TO PRACTICE Every legislative session brings decisions that directly influence how physicians care for patients.

IMS works at the Capitol to protect physician-led care, strengthen liability protections, and advance sound public health policy. Your membership amplifies that voice. When IMS speaks, policymakers know we represent thousands of physicians and future physicians across specialties

PROTECTING PHYSICIAN WELLNESS AND PROFESSIONAL SATISFACTION Burnout continues to affect physicians at alarming rates. IMS addresses this challenge head-on.

IMS offers programming, tools, and advocacy, designed to help reduce administrative burden and support physician resilience.

Your membership connects you with physicians you may never meet otherwise, building a statewide network that understands your unique challenges and is committed to your success. Through regional events, education, leadership development, and committee service, IMS offers many ways for members to engage, collaborate, and lead.

WHY MEMBERSHIP MATTERS NOW MORE THAN EVER Health care is evolving rapidly.

New technologies, workforce pressures, and shifting regulatory requirements create challenges that no physician or practice should have to navigate alone. Iowa Medical Society membership ensures that Iowa physicians remain equipped, represented, and united. When physicians join/renew, they strengthen a collective legacy that advances patient care, protects professional integrity, and supports the future of medicine in our state.

If you haven't already, scan here to join or renew your IMS membership!

Join/Renew today! Encourage your colleagues to become IMS members to strengthen the future of your profession in Iowa.

And a special thank you to all the IMS members who have already renewed for 2026! ■

IMS launched multiple ad campaigns in 2025 featuring member stories to encourage membership

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EVENTS AND EDUCATION Check out our full list of educational webinars and events

2026 EDUCATION AND EVENTS IMS PHYSICIAN WEBINAR SERIES

CE Seminar Series

ECHO SERIES

A one-hour virtual series held Monday–Thursday at noon unless otherwise noted. Speakers and details appear on the IMS Events Calendar.

This series will be held the first Tuesday of the month starting in February as scheduling allows.

The one-hour sessions are scheduled for the noon hour unless otherwise advertised. ​

Spring Topics:​

Sessions:​

+ Infectious Disease Panel: Vaccines, Viruses, and ACIP Verdict; Thursday, March 5 12-1:00 PM via Zoom + Artificial Intelligence​ + Global Health + Oral Health is One Health: A Two-Part Series + Fluoride Research and Impact on Iowa Patients and Medical Practitioners​ + Intersection of Oral Health and the Medical System​

Jan 23: IMHE 2025 Recordings Release​

Fall Topics: + Advocacy in Action: Election Year Preparation + Immunization Schedule Updates + Motivational Interviewing

STUDENT/RESIDENT EDUCATIONAL SERIES This in-person series will be held Mondays-Thursdays as scheduling allows.

The one-hour presentations are scheduled for the noon hour unless otherwise advertised with scheduling and topic subject to medical student / resident coordination needs.

Have an educational presentation or research topic suggestion?

Reach out to Kristina Seier for more information.

Physician Day on the Hill Tuesday, February 17 Board elections Call for candidates Friday, January 9 Call for candidates closes Monday, February 9 Voting opens Tuesday, March 24 Voting closes Tuesday, April 14

February 3: C-Section under Local Anesthesia ​​with Dr. Kokila Thenuwara, MD, MBBS, MME, MHCDS

Policy Forum 2026-1 Policy Forum Call to Action opens Friday, February 27

March 3: To be announced (TBA)

Policy Forum Call to Action closes Friday, March 13

April 1: TBA May 5: PMADs topic Dr. Bailey Brooks, MD​ June 2:​TBA September 1:​​TBA October 6: PMADs topic with Dr. Kirby Nelson, DNP, PMHNP-BC, PMH-C​​ November 3: ​​TBA December 1: TBA

ECHO Topics will include:​ + C-Section under Local Anesthesia ​ + Intimate Partner Violence​ + Documentation / Litigation Concerns​ + Suicide Risk and Assessment for Pregnant People + Trauma-informed care in maternal health​​ + Safe Prescribing and Treatment for Pregnant Persons with Substance Use Disorders​​ + Prenatal Screening and Assessment

CME TOPIC MENU + Advocacy & Legislative Updates​ + Operation I.O.W.A.​ + Topical based on availability

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EVENTS

Policy Forum Testimonial opens Saturday, March 14 Policy Forum Testimonial closes Saturday, March 28 Policy Forum meeting Friday, April 17 Board of Directors Reorganization Meeting Saturday, April 18 IMS President’s Dinner Friday, April 17 Pops with Docs Friday, July 3 Blitz Events New Format The Blitz events are a way for IMS to connect with members and health systems across the state.

IMS staff and board members connect with key stakeholders during the day and may provide evening CME sessions and dinner for physician members​.

Dates to be decided and shared through the Weekly Debrief and IMS events calendar.

NEW IN NORTH LIBERTY INCREDIBLE FOR IOWA Now Open!

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Because we’re here to make all of Iowa better.

To learn more, visit:

uihc.org/north-liberty

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