State of Lung Cancer 2020

Alabama

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Rate of New Cases Survival Rate Early Diagnosis Surgical Treatment Lack of Treatment Screening
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Screening -

Fee-For-Service Medicaid Coverage of Screening

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Highlighted Disparity

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Lung Cancer Rates

New Cases

New Cases:

  • The rate of new lung cancer cases is ### and #significantly# than the national rate of 58.
  • #State# ranks ### among all states, placing it in the #tier#.
  • Over the last five years, the rate of new cases #improve/change# by ###.
5-Year Survival Rate

5-Year Survival Rate:

  • The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in #State# is ###, which is #significantly# than the national rate of 24%.
  • It ranks ### among the 45 states with survival data, placing it in the #tier#.
  • Over the last five years, the survival rate in #State# #improve/change# by ###.
Stage at Diagnosis

Most lung cancer cases are diagnosed at later stages when the cancer has spread to other organs, treatment options are less likely to be curative, and survival is lower. In general, the earlier that lung cancer is diagnosed, the more likely that treatments will be effective and improve chances of survival.

Nationally, only 24% of cases are caught early when the five-year survival rate is much higher (60%) Unfortunately, most cases (46%) are not caught until a late stage when the survival rate is only 6%.

Early Diagnosis:

  • ### of cases are caught at an early stage, which is #significantly# than the national rate of 24%.
  • It ranks ### among the 49 states with data on diagnosis at an early stage, placing it in the #tier#.
  • Over the last five years, the early diagnosis rate in #State# #improve/change# by ###.

Lung Cancer Treatment

Surgical

While surgery may not be an option for every patient, those who receive it as part of their initial treatment have higher survival rates than those who do not. Patients who are not healthy enough to undergo the procedure or whose cancer has spread too far, may not be candidates for surgery. Other treatments may be recommended instead of or in addition to surgery, such as chemotherapy, radiation, targeted therapy or immunotherapy.

Surgical Treatment:

  • #State# ranked ### (out of the 49 states with available data) with ### of cases undergoing surgery as part of the first course of treatment.
  • This is #significant# than the national rate of 20.7% and puts #State# in the #tier#.
  • Over the last five years, the percent of cases undergoing surgery in #State# #improve/change# by ###.
Lack of Treatment

Not every patient receives treatment after being diagnosed with lung cancer. This can happen for multiple reasons, such as poor health or refusal of treatment. Some of these reasons may be unavoidable, but no one should go untreated because of lack of provider or patient knowledge, stigma associated with lung cancer, fatalism after diagnosis, or cost of treatment. Dismantling these and other barriers is important to reducing the percent of patients who do not receive any treatment.



Lack of Treatment:

  • #State# ranked ### (out of the 49 states with available data) with ### of cases not receiving any treatment.
  • This is #significant# than the national rate of 21% and puts #State# in the #tier#.
  • Over the last five years, the percent of cases receiving no treatment in #State# #improve/change# by ###.

Screening

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Covid-19 Impact

Nationally, screening rates have increased every year since it was first recommended. However, the national rate did not change from 2019 to 2020, likely due to COVID-19 lockdowns limiting access to healthcare resources and the public’s reticence to enter medical facilities during the pandemic.

High Risk

Screening for lung cancer with annual low-dose CT scans among those at high risk can reduce the lung cancer death rate by up to 20% by detecting tumors at early stages when they are more likely to be curable.

Based on new research, in March of 2021, the United States Preventive Services Task Force expanded its recommendation for screening to include a larger age range and more current and former smokers. This will dramatically increase the number of women and Black Americans considered at high risk for lung cancer.

Screening rates in this report are from before the guidelines were updated and do not yet reflect screening among those newly eligible.

High Risk is defined as:

  2020 Guidelines 2021 Guidelines
Age 55-80 years 50-80 years
Smoking History 30 or more pack years
(this means 1 pack a day for 30 years, 2 packs a day for 15 years, etc.)		 20 or more pack years
(this means 1 pack a day for 20 years, 2 packs a day for 10years, etc.)
Smoking Status Current smoker or quit within the last 15 years

Screening for High Risk:

  • In #State#, ### of those at high risk were screened, which was #significantly# than the national rate of 6%.
  • It ranks ### among all states, placing it in the #tier#.

For screening to be most effective in reducing the overall lung cancer mortality rate, more of the high-risk population should be screened – currently screening rates are very low among those at high risk. This may be because of a lack of access or low awareness and knowledge among patients and providers. Rates vary tremendously between states and more can be done to increase screening rates.

Medicaid Coverage

Medicaid beneficiaries are disproportionately affected by lung cancer, yet standard Medicaid programs are one of the only healthcare payers not required to cover lung cancer screening. If screening is covered, Medicaid programs may use different eligibility criteria, require prior authorization or charge individuals for their scans. The American Lung Association analyzed lung cancer screening coverage policies in state Medicaid fee-for-service programs to assess the current status of lung cancer screening coverage for the Medicaid population.

Virginia was one of the 40 states whose Medicaid fee-for-service programs covered lung cancer screening as of September 2021. In addition, their program used recommended guidelines for determining eligibility and did not require prior authorization. Coverage may also vary between fee-for-service and managed care plans within a state’s Medicaid program.

The Lung Association urges all state Medicaid programs to cover lung cancer screening based on evidence-based guidelines across all fee-for-service and managed care plans and to remove any financial or administrative barriers that limit access to this lifesaving service.

Medicaid Coverage:

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Prevention

Tobacco
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Tobacco use is the leading risk factor for lung cancer. Smoking and secondhand smoke both have been shown to cause lung cancer.

State of Tobacco Control

Each year the Lung Association publishes the "State of Tobacco Control" report. The 2021 report grades all 50 states and the federal government on four key tobacco control policies: tobacco control and prevention spending, smokefree air, tobacco taxes, and cessation coverage.
View Report Card

Tobacco Use:

  • The smoking rate in #State# is ### and #significant# than the national rate of 15%.
  • It ranks ### among all states, placing it in the #tier#.
Radon
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Radon is the second leading cause of lung cancer.
Radon is a colorless and odorless gas that can seep into homes and buildings. Some geographical areas naturally have higher average radon levels than others, but since any home can be at risk for elevated levels, the only way to know is to do a test. If testing shows interior radon levels at or above the U.S. EPA action level of 4 pCi/L (picoCuries per liter of air) or higher, it is recommended you take corrective measures to reduce your exposure to radon gas. Such measures should also be considered at levels at or above 2 pCi/L.

Radon:

  • In #State#, ### of radon tests results were at or above the action level recommended by EPA.
  • It ranks ### among all states, placing it in the #tier#.
Air Pollution
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Air Pollution is a known risk factor for lung cancer. Long-term exposure to outdoor particle pollution is known to cause lung cancer.

State of the Air

Each year the Lung Association publishes the "State of the Air" report. The 2021 report grades U.S. counties on harmful particle pollution and ozone pollution recorded over a three-year period, and details trends for metropolitan areas over the past two decades. The report also ranks the cleanest and most polluted areas in the country.
View Report Card

Racial & Ethnic Disparities

Black

Black Americans:

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Latino

Latino Americans:

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Asian & Pacific Islander

Asian Americans or Pacific Islanders:

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Indigenous People

Indigenous Peoples:

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Summary

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Dynamic link for individual state infographic PDF

 

What Can I Do?

You can lower their risk of lung cancer, as well as the risk of those around you, through these steps: