Utah has the highest skin cancer rate in the United States, with 42.7 melanoma cases per 100,000 people based on 2018–2022 data from the National Cancer Institute. That’s nearly double the national average of 23.1 per 100,000. The runners-up may surprise you: Minnesota, Vermont, Iowa, and Idaho round out the top five, none of them the sun-drenched Southern states most people would guess.
The Top 5 States for Melanoma
The states with the highest age-adjusted melanoma incidence rates per 100,000 people are:
- Utah: 42.7
- Minnesota: 38.8
- Vermont: 35.1
- Iowa: 32.8
- Idaho: 32.4
These numbers reflect melanoma specifically, the most dangerous form of skin cancer. The two more common types, basal cell and squamous cell carcinoma, are not tracked by cancer registries in the United States. That means there’s no reliable state-by-state comparison for those cancers. When people talk about skin cancer rankings by state, they’re almost always talking about melanoma.
Why Utah, Not Florida or Arizona?
Utah’s position at the top of the list seems counterintuitive until you look at the combination of factors working against its residents. The Utah Department of Health and Human Services points to the state’s high elevation and large number of sunny days as key contributors. UV radiation intensifies at higher altitudes because there’s less atmosphere to filter it. Salt Lake City sits above 4,200 feet, and much of the state’s population lives at similar elevations. Residents who spend time in the mountains for skiing, hiking, or camping are exposed to even stronger UV levels.
Demographics play a major role too. Utah has a predominantly non-Hispanic White population, and fair skin is one of the strongest risk factors for melanoma. Lighter skin produces less of the pigment that provides some natural protection against UV damage. People with blue or green eyes, red or blond hair, and skin that freckles or burns easily face the highest risk. Utah, Minnesota, Vermont, Iowa, and Idaho all share this demographic profile, which helps explain why they cluster at the top of the rankings despite their northern latitudes.
Outdoor culture matters as well. States where people spend significant time outside for recreation expose their residents to more cumulative UV radiation over a lifetime. A history of sunburns, especially blistering sunburns early in life, is one of the controllable risk factors most strongly linked to melanoma.
Total Cases vs. Rate Per Person
There’s an important distinction between having the highest rate and having the most total cases. When you look at raw numbers rather than per-capita rates, the picture flips entirely. The American Cancer Society’s 2025 projections estimate California will see 2,480 new melanoma cases this year, followed by Florida with 1,830 and Texas with 1,750. These states have the most total cases simply because they have the largest populations.
But a resident of Utah is far more likely to be diagnosed with melanoma than a resident of California or Texas. Per-capita rates tell you about individual risk, while total case counts reflect population size. If you’re trying to understand your personal likelihood of developing skin cancer based on where you live, the rate per 100,000 is the more useful number.
Why Sunbelt States Rank Lower Than Expected
Florida, Arizona, and Texas get more intense sunshine than Minnesota or Vermont, yet their melanoma rates are lower. Several factors explain this. These Southern states have more racially and ethnically diverse populations. Melanoma is significantly more common in non-Hispanic White individuals, so states with larger Hispanic, Black, and Asian populations tend to have lower overall rates even when UV exposure is high.
Hawaii offers a useful example. Despite being a tropical state with year-round sun exposure, Hawaii’s melanoma rate is only 24.9 per 100,000, barely above the national average. Hawaii’s diverse population, which includes large Native Hawaiian, Asian, and Pacific Islander communities, brings its overall melanoma rate down considerably.
Behavior also factors in. People living in extremely hot climates may actually spend less time outdoors during peak UV hours, seeking shade and air conditioning instead. Meanwhile, residents of Northern states often maximize their outdoor time during warmer months, sometimes without adequate sun protection because they don’t associate their climate with skin cancer risk.
Risk Factors You Can Control
Where you live is only one piece of the puzzle. The controllable risk factors for melanoma center on UV exposure. Sunburns are a major one, particularly blistering burns during childhood and adolescence. Tanning beds are another significant source of artificial UV radiation. Cumulative sun exposure over years and decades also raises risk, which is why melanoma becomes more common with age.
Family history and having many moles increase your risk regardless of where you live. But the factors within your control, consistent sunscreen use, protective clothing, avoiding peak sun hours, and skipping tanning beds, apply whether you’re in Utah or Alabama. People in high-altitude states should be especially aware that UV exposure increases roughly 4–5% for every 1,000 feet of elevation gain, making sun protection during mountain activities particularly important.