An estimated one in five Americans will develop skin cancer in their lifetime. Diagnosis rates of melanoma — one of the most common and deadly forms of skin cancer — doubled in the United States between 1982 and 2011. Meanwhile, skin cancer treatment cost Americans $8.1 billion a year from 2007 to 2011, more than twice the annual cost in the previous five years.

While melanoma is the deadliest form of skin cancer, basal cell carcinoma and squamous cell carcinoma account for the vast majority of skin cancer diagnoses. If detected early and treated properly, both types are highly curable.

The much less common melanoma is a more aggressive form of skin cancer, accounting for about three out of every four skin cancer deaths. Melanoma is expected to account for 76,000 cases of skin cancer, and 10,000 deaths in 2016.

The incidence of melanoma varies among states. To determine which states have the highest rates of melanoma, 24/7 reviewed data from the Centers for Disease Control and Prevention. Texas has the lowest rate in the country with 12 cases of melanoma for every 100,000 residents annually. The rate in Utah is more than three times higher, at 37.3 melanoma diagnoses for every 100,000 people — the highest of any state.

40. Michigan

> Melanoma diagnoses: 18.7 per 100,000
> Melanoma deaths: 2.5 per 100,000 (tied-18th lowest)
> Pct. pop. white: 79% (25th highest)

Many factors contribute to a state’s melanoma rate. Because more than 90% of melanoma cases are diagnosed in non-Hispanic whites, states with larger shares of light-skinned residents tend to report a greater incidence of melanoma. Nine of the 10 states with the highest rates of melanoma have populations with higher proportions of white residents than the nation as a whole. This is true for only four of the 10 states with the lowest rates of melanoma.

Exposure to ultraviolet light from the sun, particularly to the point of sunburn, increases the risk of melanoma. Sunny, Southern states do not have higher rates of melanoma, however. The difference between states may be caused more by how residents protect themselves from the sun, rather than how much time they spend in the sunlight. For example, residents living in cloudier areas may not use sunscreen as much as a resident living in sunny areas, even though the majority of the ultraviolet radiation penetrates the clouds.

To identify the states with the highest rates of skin cancer, 24/7 Wall St. reviewed melanoma diagnosis and death rates per 100,000 people from the Centers for Disease Control and Prevention. Figures are for 2013, the most current available. Percentages of state populations who are white came from the U.S. Census Bureau’s 2014 American Community Survey. Nevada was excluded from the list because melanoma rates were not available.

Click here to see the states with the most skin cancer.