Surpassed by only heart disease, cancer is second leading cause of death in the United States. There are roughly 448 cases of cancer per 100,000 Americans, accounting for 22.5% of all deaths nationwide. In the Dallas-Fort Worth-Arlington metro area, an estimated 426 out of every 100,000 residents have been diagnosed with cancer, lower than the national figure and the tenth highest of any city in Texas.

One of the most common forms of cancer occurs in the lung and bronchial tubes. In the Dallas metro area, 57 out of every 100,000 residents have been diagnosed with lung cancer, a lower incidence than the national rate of 62.1 cases per 100,000 Americans. According to the American Lung Association, smoking is responsible for 80% of all lung cancer deaths among women and 90% among men. Dallas’s low incidence of lung cancer may be associated with the city’s low smoking rate. An estimated 14.3% of Dallas adults smoke regularly, lower than the 17.0% national rate and the fourth lowest of any metro area in Texas. Across the state, 14.5% of adults smoke.

In addition to smoking, there are a number of unhealthy behaviors that can increase the likelihood of cancer. In Dallas, 24.5% of adults report getting no physical activity outside of work whatsoever, compared to the national inactivity rate of 23.0%. Active lifestyles may put some Dallas residents at a lower risk of obesity, a condition which can make the odds of developing certain forms of cancer nearly twice as likely. Roughly 27% of adults in the Dallas metro area are obese, compared to 27.0% of American adults nationwide.

While healthy eating and exercise have been known to decrease the likelihood of cancer, some of the most important practices for cancer prevention are regular screening tests and follow-ups. According to guidelines issued by the American Cancer Society, women 55 and older should receive an x-ray breast cancer screening every two years. In the U.S. however, just 63.0% of elderly female Medicare enrollees have one mammogram every two years. Breast cancer screening is less common in Dallas, where 61.1% of senior female Medicare enrollees have mammograms as frequently as the ACS recommends.

One of the largest socioeconomic predictors of disease and mortality is income. Wealthier Americans often lead healthier lifestyles, have less exposure to harmful pollutants, and are more likely to have health insurance that can provide access to preventative medical care.

The typical household in the Dallas-Fort Worth-Arlington metro area earns $61,644 a year, more than the $55,775 national median household income. The U.S. Census Bureau estimates that 16.3% of Dallas residents lack health insurance, compared to 9.4% of all Americans. Counting all causes of death before the age of 75, 326 out of every 100,000 Dallas residents die prematurely, less than the national premature mortality rate of 474 deaths per 100,000 Americans.