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 Houston-The Woodlands-Sugar Land metro area, an estimated 422 out of every 100,000 residents have been diagnosed with cancer, lower than the national figure and the 13th lowest of any city in Texas.

One of the most common forms of cancer occurs in the lung and bronchial tubes. In the Houston metro area, 56 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. Houston’s low incidence of lung cancer may be associated with the city’s low smoking rate. An estimated 13.8% of Houston adults smoke regularly, lower than the 17.0% national rate and the third 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 Houston, 22.0% of adults report getting no physical activity outside of work whatsoever, compared to the national inactivity rate of 23.0%. A sedentary lifestyle may put some Houston residents at a higher risk of obesity, which can nearly double the odds of developing certain forms of cancer. Roughly 27% of adults in the Houston 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 Houston, where 56.6% 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 Houston-The Woodlands-Sugar Land metro area earns $61,465 a year, more than the $55,775 national median household income. The U.S. Census Bureau estimates that 17.3% of Houston residents lack health insurance, compared to 9.4% of all Americans. Counting all causes of death before the age of 75, 327 out of every 100,000 Houston residents die prematurely, less than the national premature mortality rate of 474 deaths per 100,000 Americans.