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 Washington-Arlington-Alexandria metro area, an estimated 400 out of every 100,000 residents have been diagnosed with cancer.

One of the most common forms of cancer occurs in the lung and bronchial tubes. In the Washington metro area, 46 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. Washington’s low incidence of lung cancer may be associated with the city’s low smoking rate. An estimated 13.1% of Washington adults smoke regularly, lower than the 17.0% national rate and the lowest of any metro area in District of Columbia. Across the state, 15.8% of adults smoke.

In addition to smoking, there are a number of unhealthy behaviors that can increase the likelihood of cancer. In Washington, 18.8% 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 Washington residents at a higher risk of obesity, which can nearly double the odds of developing certain forms of cancer. Roughly 24% of adults in the Washington 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 Washington, where 61.2% 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 Washington-Arlington-Alexandria metro area earns $93,294 a year, more than the $55,775 national median household income. The U.S. Census Bureau estimates that 8.1% of Washington residents lack health insurance, compared to 9.4% of all Americans. Counting all causes of death before the age of 75, 277 out of every 100,000 Washington residents die prematurely, less than the national premature mortality rate of 474 deaths per 100,000 Americans. The average life expectancy at birth in the Washington metro is 80.4 years, one of the longest life expectancies of any city in the country.