Lung cancer is America’s deadliest cancer, claiming about 125,000 lives each year.

It also remains exceptionally hard to treat. Despite significant progress in developing new medicines, fewer than three in 10 patients are alive five years after receiving a diagnosis.

For generations, the disease has been viewed as almost inseparable from cigarette smoking.

Yet as tobacco use has declined sharply, physicians are increasingly diagnosing lung cancer in people who have never smoked. The trend has prompted fresh questions about less visible threats that may be raising the risk for Americans.

A Daily Mail review of federal data has now highlighted one compelling factor: a person’s location may play a major role.

The county-by-county map above reveals an expansive cluster of lung cancer hotspots across much of the South and Midwest, in contrast with far lower rates across broad areas of the West.

Scientists are working to explain the disparity, examining potential contributors ranging from naturally occurring radioactive gas inside homes to pollution, genetic factors and exposure to second-hand smoke.

What is driving this stark national divide in lung cancer, and could overlooked hazards in your home or community be increasing your risk?

Smoking remains one of the most straightforward explanations.

Cigarette smoking has plunged nationwide over recent decades. In the 1960s, 42 percent of US adults smoked; by 2022, the share had fallen to only 11.6 percent.

Lung cancer rates have followed, falling by around 30 percent since 1992. But the relationship between the two is not immediate.

Cigarette smoke contains thousands of chemicals, dozens of which are known to cause cancer. 

Repeated exposure damages the DNA inside lung cells, allowing mutations to accumulate over many years until cells can begin multiplying uncontrollably and form a tumor. 

Smoking remains linked to around 80 percent of lung cancer deaths in the US.

Crucially, quitting does not wipe out that risk overnight. It takes around 10 to 15 years for a former smoker’s additional risk of lung cancer to fall by half compared with someone who continues smoking.

That means America is still living with the legacy of generations who smoked when the habit was far more common. And that legacy is clearly visible on the map.

The states where smoking remains most common are also among those suffering the highest rates of lung cancer.

West Virginia and Arkansas, for example, are among the states with the highest smoking rates in America – and also among those with the highest rates of lung cancer. 

By contrast, Utah and California have some of the country’s lowest smoking rates and some of its lowest lung cancer rates.

But there are intriguing exceptions to the pattern – suggesting smoking may not be the whole story. 

One potential explanation lies beneath the ground.

Radon is a colorless, odorless radioactive gas produced naturally as uranium in rocks and soil breaks down. It can seep through cracks and gaps in buildings and, in poorly ventilated homes, accumulate to dangerous levels. 

When inhaled over many years, radioactive particles from the gas can damage cells lining the lungs, potentially triggering cancer.

It is already considered the second-leading cause of lung cancer in America after smoking, responsible for an estimated 21,000 deaths from the disease each year.

And, crucially, exposure also varies dramatically depending on where you live.

Federal data shows the highest-risk radon zones are concentrated across large parts of the Midwest, Northeast and Northwest – including some areas with high lung cancer rates.

Of the ten states with the highest proportion of counties in the most dangerous radon category, Maine and Indiana are also among the ten states with the highest lung cancer rates.

And of the 24 US counties where lung cancer rates are still rising, 11 – almost half – are in the highest-risk radon zone.

But the relationship is far from straightforward.

Dr Amit Mahajan, a pulmonologist and spokesman for the American Lung Association, said: ‘If you look at areas in the Midwest and the upper Northwest, you see higher exposure to radon.

‘That doesn’t necessarily equate to the development of lung cancer, but it is a driver of lung cancer in nonsmokers. It happens via exposure that takes place over decades.’

Perhaps most intriguingly, some parts of the West have high radon levels but remarkably low rates of lung cancer.

Mahajan believes one explanation could be how Americans live in different parts of the country.

‘In colder areas, such as Maine and Indiana, which have both high radon exposure and high lung cancer rates, people will close up their houses for the winter months, which can lead to radon levels rising in the home, posing a greater risk,’ he said.

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‘But in warmer areas, such as California, where radon exposure is also high but lung cancer rates are among the lowest in the country, people may keep their homes open year-round, reducing the build-up of the gas.’

The worrying part is that it isn’t easy to tell if you are being exposed.

Radon cannot be seen, smelt or tasted, meaning dangerous levels can accumulate inside a home without its occupants realizing.

The only way to know is to test. Home radon testing kits are widely available and can cost as little as $20.

For Rachael Malmberg, the danger lurking inside her home only became apparent after she was diagnosed with stage four lung cancer at just 31.

The former Olympic ice hockey player from Minnesota had never smoked and was young, fit and healthy when she developed the disease.

Searching for an explanation for her diagnosis led her to radon. She tested her home and discovered levels of the radioactive gas were dangerously high.

Malmberg had a radon mitigation system installed to remove the gas – and urged her neighbors to test their homes, too.

Three did. All three also discovered high radon levels.

Experts say stories like hers underline why testing is so important. Because radon has no color or smell, there is no way to know whether it has accumulated inside a home without measuring it.

Radon, however, is not the only environmental threat researchers are investigating.

Another is the air Americans breathe.

Tiny particles produced by cars, factories and other sources of pollution can be inhaled deep into the lungs, where they can damage cells and trigger inflammation.

Of particular concern is PM2.5 – particles so small they can penetrate deep into lung tissue and have been linked to lung cancer.

But here, too, the geographic picture is complicated.

Air pollution has fallen dramatically across the US in recent decades, dropping 78 percent since the 1970s. And today, some of the highest levels of PM2.5 are found in the West – the very region where lung cancer rates are lowest.

Of the 17 states with the highest PM2.5 levels, just two – Indiana and Ohio – are also among the ten states with the highest lung cancer rates.

Mahajan said this suggests pollution is unlikely to explain the stark divide on its own.

‘With air pollution, it is more likely that it will exacerbate or cause people to develop other conditions such as emphysema or asthma,’ he said.

‘But being exposed to air pollution doesn’t mean you have a higher risk of lung cancer per se. It’s more the cumulative effect of that plus other risk factors, such as smoking.’

And some people may be more vulnerable to lung cancer because of factors they are born with. 

Scientists have identified a number of genetic mutations linked to the disease, including changes to a gene known as EGFR, which normally helps control how cells grow and divide.

When EGFR becomes mutated, it can cause cells to multiply uncontrollably, potentially leading to cancer.

These mutations are particularly important because they are disproportionately found in lung cancer patients who have never smoked.

There is also a striking ethnic divide.

Studies suggest EGFR mutations are found in around 39 to 51 percent of Asian lung cancer patients, compared with roughly ten percent of those of European ancestry.

Scientists do not yet fully understand why – or whether there is any way to identify healthy people at particular risk before cancer develops.

Other threats are better established.

Regular exposure to second-hand cigarette smoke has long been known to increase lung cancer risk, even among people who have never smoked themselves.

What remains much less certain is the long-term impact of vaping.

E-cigarettes have not existed for long enough for scientists to establish whether they cause lung cancer, a disease that can take decades to develop. But the American Lung Association says it is ‘very troubled’ by emerging evidence about their effects on the lungs, noting that e-cigarette vapor can contain potentially toxic substances.

For Mahajan, the emerging evidence points to a much more complicated picture of America’s deadliest cancer than was once believed.

‘We are seeing more lung cancer cases in patients who have never smoked, but it is hard to tell whether this is an increase or just because we are getting better at identifying the disease,’ he said.

‘In the past, we’ve been much more focused on just smokers. But it is clear that that picture is changing.’

Juan Soto failed to hustle out of the batter’s box for a second consecutive at-bat, and former Mets pitcher Ron Darling took notice.

One night after he did not sprint toward first on a game-ending double-play ball, the Mets’ $765 million star followed Francisco Lindor’s leadoff homer Saturday afternoon at Yankee Stadium by hitting a grounder to second base.

Anthony Volpe, a converted shortstop still adjusting to second base, bobbled the grounder. Soto then accelerated down the line, but Volpe recovered in time to narrowly retire the Mets designated hitter at first.

Darling stopped short of a full-blown criticism, but he made clear that Soto should have been running hard from the start.

“If you’re not going to run, things like that are going to happen,” Darling said on SNY. “Bobbled. If you don’t run out of the box, then you end up being embarrassed. DHing today because last night, I don’t know what his physical ailments are; he can’t play left field in this ballpark right now.”

Soto also appeared not to give a full effort on Ryan McMahon’s single to left in the eighth inning Friday night, allowing a run to score and helping the Yankees extend their lead to 6-3. New York went on to win, 6-4.

“He had two balls drop in front of him last night. If you do the math, it might have cost the Mets the game,” play-by-play announcer Gary Cohen added.

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Cohen also pointed to the injuries Soto has dealt with in “both calves” this season.

Those issues could be limiting his mobility or making him more hesitant to run at full speed.

Soto spent two and a half weeks on the injured list in April with a right calf strain, a stretch in which the Mets endured a season-defining 12-game losing streak without him.

He then missed 31 more games over July and August with a Grade 2 left calf strain. Soto returned to the lineup on Aug. 29.

He seemed to put any questions about his calf to rest when he hustled out a double in the top of the fourth inning, tagged up to third and then scored on a Carson Benge single. 

 “He showed no issues with his calf,” Keith Henrndez said. “He ran like the devil on that double.” 

Soto then mashed a mammoth solo home run in the seventh to extend the Mets’ lead to 6-2.

A Southern California diner that once drew the likes of the Kardashians, Britney Spears and other celebrities has sought bankruptcy protection after 36 years in operation.

Marmalade Cafe, a longtime Los Angeles County neighborhood restaurant, filed for Chapter 11 bankruptcy on September 2 as supplier bills, rent disputes and ongoing financial losses prompted the chain to sharply reduce its presence.

The California-inspired cafe built a particularly high profile in star-studded Calabasas, where members of the Kardashian family were regularly seen at its location in The Commons shopping center.

Kourtney Kardashian was photographed having lunch with her children at the Calabasas restaurant in 2013. She returned the next year, when she was spotted there celebrating her 35th birthday.

Kris Jenner was also photographed dining at Marmalade Cafe, while Britney Spears was pictured collecting lunch and coffee from the Calabasas location.

That Calabasas restaurant, which had been open for almost three decades, shut down on August 1. Its closure followed the July shutdown of another Marmalade Cafe site in Santa Monica.

The future of the remaining Marmalade Cafe chain is now uncertain.

The Encino-based owner of Marmalade Cafe submitted a Subchapter V Chapter 11 petition to the U.S. Bankruptcy Court for the Central District of California, reporting assets and liabilities of between $1 million and $10 million.

For its loyal patrons, the closures represent a striking shift for a restaurant brand that was once a familiar fixture throughout Southern California.

Marmalade Cafe opened its first restaurant on Montana Avenue in Santa Monica in 1990 and eventually grew to eight locations.

It has since lost four restaurants, leaving just four still operating in Malibu, El Segundo, Sherman Oaks and Westlake Village.

The company said in its bankruptcy filing that it had been suffering from ‘unsustainable financial losses and a lack of rent relief’ at some of its locations. It also cited rent disputes and mounting debts to suppliers and vendors.

Among its largest unsecured creditors are Gilmore Farmers Market, which the company owes more than $481,000, US Foods, owed more than $394,000, and the California Department of Tax and Fee Administration, owed more than $349,000.

It also owes Sunrise Produce more than $293,000 and Sysco Ventura more than $239,000. The bankruptcy filing lists between 50 and 99 creditors, with more than $2.4 million in unsecured debt identified among 20 named creditors.

A balance sheet included in the filing puts the company’s total assets at about $12.7 million, while its net income was negative $680,314.

Marmalade Cafe’s financial troubles have also taken a heavy toll on its workforce. The company said it once employed more than 200 people but began downsizing in 2024, leaving approximately 50 employees by the middle of this year.

The latest closures have happened at a rapid pace. The chain’s original Montana Avenue restaurant closed in May 2024, ending more than three decades at the location where the brand began.

Its Original Farmers Market restaurant in Los Angeles followed in May 2026.

The Santa Monica Boulevard location closed in July, with the company having previously sought someone to take over its lease, which cost around $18,000 a month.

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Then, on August 1, the Calabasas restaurant closed after 28 years serving the community. In a message to customers, Marmalade Cafe said it was ‘deeply grateful’ for the friendships and memories created at the restaurant and directed customers toward its remaining locations.

The chain’s history stretches back to an era when neighborhood cafes were a major part of Southern California dining culture.

From its original Santa Monica restaurant, Marmalade Cafe expanded into a casual, full-service concept offering a broad menu designed to appeal to customers throughout the day.

But the restaurant’s long history has not insulated it from the financial pressures hitting the wider dining industry.

Restaurants have been dealing with higher labor, food and occupancy costs, while customers have also become more price-conscious.

Marmalade Cafe’s bankruptcy comes amid a difficult year for restaurants, with a number of chains shrinking their footprints, seeking bankruptcy protection or closing altogether.

New York-based Fireman Hospitality, whose portfolio includes Café Fiorello, filed for Chapter 11 in August, citing financial difficulties and debt obligations.

Salad and Go also filed for bankruptcy in August and closed its remaining locations, while other chains have been cutting their footprints across the country.

California has seen its own wave of restaurant closures. Carl’s Jr. closed dozens of Southern California locations earlier this year, while a Red Lobster restaurant in Palm Desert shut after 14 years.

Marmalade Cafe’s Chapter 11 filing does not necessarily mean the remaining four restaurants will close.

Chapter 11 allows a business to continue operating while it attempts to reorganize its finances, restructure debts and reach agreements with creditors.

That means customers in Malibu, El Segundo, Sherman Oaks and Westlake Village may still be able to visit their local Marmalade Cafe while the bankruptcy case plays out.

The news has prompted a mixed reaction online, with some former customers expressing nostalgia for the chain while others have been far less complimentary.

One Reddit user summed up the divide by writing that the restaurant was ‘a shell of its former self’ after the pandemic.

Another complained that its prices had become too high, writing that the food was ‘overpriced.’

Others said they would miss it. One Sherman Oaks customer praised the restaurant’s pot roast, Italian salad, mushroom soup and egg dishes and said they hoped the chain would reorganize and stay open.

‘I love the variety of the menu and can always find something I’m craving,’ another Reddit user wrote.

One commenter recalled going to the Sherman Oaks location for happy hour after work, while another said they had enjoyed the restaurant with their mother before she died.

For now, the fate of the remaining four restaurants remains uncertain. After 36 years in Southern California, the chain is hoping its next chapter will not be its last.

Dramatic body-camera video captures the moment Santa Monica police officers shot a man who allegedly charged at them with a knife while they were handling an unrelated incident.

The footage shows two officers speaking with witnesses about a separate matter near the busy Santa Monica Pier on Aug. 22 when they notice a man approaching with a serrated knife raised above his head.

As the man continued toward them, both officers repeatedly shouted, “Put that down!” while backing away.

When the man accelerated toward the officers, one officer fired a single shot to his chest, according to the video. He then dropped the knife.

An officer is then seen kicking the knife away from the suspect before beginning CPR.

The Los Angeles County Medical Examiner identified the man as 44-year-old Michael Rodriguez. He later died at a hospital.

No officers or bystanders were hurt. Authorities said they recovered two additional knives from Rodriguez, one on his person and another in his backpack.

The knife Rodriguez was holding when he charged at officers had a hilt featuring a sharp, serrated edge resembling that of a combat knife.

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A sheathed knife found in his backpack appeared similar. Police said another knife recovered from his pocket had a metal grip with holes and material wrapped around it.

It remains unclear what prompted Rodriguez to charge at the officers.

Santa Monica Police Chief Darrick Jacob released a statement about the department’s responsibility to be transparent about the incident.

“Our officers answer calls for help knowing the circumstances can change in an instant. On August 22, they encountered an armed individual while assisting with an unrelated call,” Jacob said.

“I recognize the lasting impact an incident like this can have on the officers and personnel who responded, and they have my support. When a life is lost during a police encounter, our responsibility to provide a clear and open account is especially important. Releasing this video is an important step in providing that account to our community,” he added.

Santa Monica Mayor Caroline Torosis praised the officers’ response to the incident.

“I am grateful for the courage our officers showed in the face of an armed threat and for
the lifesaving efforts that followed,” Torosis said.

“Our officers are part of this community, and violence against them puts everyone around us at risk. Their safety is inseparable from the safety of the people they serve. The officers and personnel who responded that day deserve our gratitude and support for their bravery, compassion, and commitment to Santa Monica,” she added.

Several investigations — including an officer-involved shooting review from the Los Angele County District Attorney’s Office, an internal Santa Monica Police Department inquiry, and a criminal investigation into the incident — remain ongoing.

A former Democratic mayor from the small Northern California town of Windsor was found civilly liable Friday over allegations that he sexually assaulted seven women.

Dominic Foppoli, who served as Windsor’s mayor from late 2018 until 2021, was ordered to pay $13 million in total compensatory damages. The women’s individual awards, tied to allegations dating from 2001 through 2020, range from $6,000 to $4,650,938.

The former mayor may also face additional punitive damages. That portion of the civil proceedings is scheduled to begin Tuesday, KTVU FOX 2 reported.

Foppoli has repeatedly denied the accusations and was never criminally charged in relation to them. He resigned as mayor in May 2021, after four women shared sexual assault allegations against him with the San Francisco Chronicle.

The lawsuit, brought in April 2022 on behalf of seven women identified as Jane Does, outlined a series of allegations against Foppoli. Several plaintiffs said he drugged their drinks before assaulting them. Jane Doe 1 alleged that he raped her dozens of times, including an incident in which she said he restrained her to a bed with handcuffs.

In all, 13 women have accused Foppoli of sexual assault or other misconduct, according to the San Francisco Chronicle.

California’s attorney general’s office paused its criminal investigation in 2024, saying there was insufficient evidence at the time to pursue charges in cases that remained within the statute of limitations.

Foppoli took the stand during the civil trial, which opened in July, and again rejected every allegation made against him.

“I’ve been a terrible boyfriend and partner, cheating, selfish and egotistical, but I’ve never done any of those things I’m being sued for,” Foppoli testified, according to KGO Eyewitness News.

The jury also found the Santa Rosa chapter of Active 20-30, an all-male charitable social club where Foppoli was a member, liable for Jane Doe 4’s alleged assault and awarded her an additional $2 million, the Chronicle reported.

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According to the lawsuit, the woman alleged Foppoli sexually assaulted her during the national Active 20-30 convention in Reno, Nevada, in June 2012. She also accused the organization of failing to investigate complaints she made to its leaders.

Traci Carrillo, an attorney for the plaintiffs, hailed the verdict as the “ultimate validation” for the women, saying they had to overcome “their trauma, their shame, their own guilt” to obtain justice.

Foppoli’s attorney, Andrew Watters, said in a statement to News Media that he would seek a mistrial over claims that the court improperly excluded key witnesses for the defense. If that fails, Watters said he would pursue an appeal.

“What happened with the verdict was that the jury sent a message based on questionable self-reported evidence and junk science, and that’s not appropriate.  It appears the passions of the jury were inflamed by the evidence and they hated my client, so they made a very large award to punish and make an example of him,” Watters said in a statement.

Foppoli, speaking at a press conference outside the courthouse Friday, said his accusers “are trying to crucify me for a cause I’m not responsible for,” adding that they were motivated by the $13 million payout.

Foppoli still faces a separate lawsuit from Farrah Abraham, a social media influencer and former reality television personality who claims the ex-politician raped her in March 2021 at a house party in Florida. That civil case is expected to go to trial next year, according to court records.

The Chronicle reported that Christopher Creek Winery, which Foppoli owns, settled a separate lawsuit filed by a Montana woman who alleged Foppoli raped her multiple times in 2020 when she was 18.