The Impact of Climate Vulnerability on Cancer Incidence Among U.S. Women.

Background and aim While climate change and its impacts have intensified in the U.S. over the past decade, the relationship between cancer incidence and regional climate vulnerability among women, particularly racial and ethnic minorities, remains largely underexplored. Climate-related environmental exposures, such as extreme weather events, air pollution, and ultraviolet radiation, are linked to risk factors for melanoma, lung, and breast cancers, yet national-level assessments across regions with differing climate impacts are limited. Understanding how these patterns vary geographically and among populations is critical for identifying emerging health disparities. This study aimed to examine the association between cancer incidence trends and state-level climate-impact categories among U.S. women, with additional stratification by racial and ethnic groups. Methods U.S. states were categorized into three climate impact levels (high, moderate, and low) based on climate data from federal, insurance, and nonprofit reports. We used the United States Cancer Statistics data to identify 6,728,838 climate change-associated cancers (cutaneous melanoma, lung, and breast) diagnosed from 2001 to 2019. Statistical analyses were performed to examine incidence trends for these cancers. Results High climate impact states experienced larger increases in cutaneous melanoma (average annual percent change (AAPC) 2.82%; p = 0.002), lung cancer (AAPC -0.94%; p < 0.001), and breast cancer incidence (AAPC 0.34%; p = 0.008) compared to low climate impact states (cutaneous melanoma: 2.24%, p < 0.001; lung cancer: AAPC -1.34%, p < 0.001; breast cancer: -0.31%, p = 0.03). Analysis by race/ethnicity showed that breast cancer incidence in high-impact regions increased among Black (AAPC 2.29%; p = 0.001), Hispanic (AAPC 2.21%; p = 0.003), and Asian women (AAPC 0.90%; p < 0.001) but decreased among White women (AAPC -0.52%; p < 0.001). Conclusions Our results indicate that cancer incidence patterns among U.S. women vary across climate impact categories and racial groups, suggesting that climate vulnerability may contribute to persistent disparities in melanoma, lung, and breast cancer trends. Women living in higher climate-impact regions experienced less favorable incidence patterns, particularly among racial and ethnic minority populations. Although these findings are ecological in nature, they highlight population-level associations that warrant further investigation using individual-level exposure data and accounting for socioeconomic and healthcare-related factors. As climate-related hazards continue to intensify, these results underscore the importance of integrating climate vulnerability into cancer surveillance, prevention strategies, and policies aimed at reducing environmental and health inequities.