Florida
Fee-For-Service Medicaid Coverage of Screening
Covered and Using Updated Guidelines
Highlighted Disparity
Black Americans in Florida are least likely to receive surgical treatment.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 56 and not significantly different than the national rate of 57.
- Florida ranks 22nd among all states, placing it in the average tier.
- Over the last five years, the rate of new cases improved by 10%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Florida is 27%, which is significantly higher than the national rate of 25%.
- It ranks 14th among the 46 states with survival data, placing it in the above average tier.
- The change in the survival rate over the last five years is not available for Florida.
Early Diagnosis:
- 25% of cases are caught at an early stage, which is significantly lower than the national rate of 26%.
- It ranks 37th among the 49 states with data on diagnosis at an early stage, placing it in the average tier.
- Over the last five years, the early diagnosis rate in Florida improved by 7%.
Lung Cancer Treatment
Surgical Treatment:
- Florida ranked 20th (out of the 49 states with available data) with 21% of cases undergoing surgery as part of the first course of treatment.
- This is not significantly different than the national rate of 21% and puts Florida in the average tier.
- Over the last five years, the percent of cases undergoing surgery in Florida did not change significantly.
Lack of Treatment:
- Florida ranked 44th (out of the 49 states with available data) with 25% of cases not receiving any treatment.
- This is significantly higher than the national rate of 21% and puts Florida in the below average tier.
- Over the last five years, the percent of cases receiving no treatment in Florida did not change significantly.
Screening
Screening for High Risk:
- In Florida, 3% of those at high risk were screened, which was significantly lower than the national rate of 6%.
- It ranks 40th among all states, placing it in the below average tier.
Medicaid Coverage:
- Florida was one of the 46 states whose Medicaid fee-for-service programs covered lung cancer screening as of July 2022.
- While their program used recommended guidelines for determining eligibility, it did require prior authorization and copays.
Prevention
Tobacco Use:
- The smoking rate in Florida is 15% and not significantly different than the national rate of 14%.
- It ranks 24th among all states, placing it in the average tier.
Radon:
- In Florida, 12% of radon tests results were at or above the action level recommended by EPA.
- It ranks 11th among all states, placing it in the above average tier.
Racial & Ethnic Disparities
Black Americans:
- The rate of new lung cancer cases is 43 per 100,000 population among Black Americans in Florida, significantly lower than the rate of 59 among Black Americans nationally, and significantly lower than the rate of 63 among whites in Florida.
- The five-year survival rate is 22% among Black Americans in Florida, not significantly different than the rate of 22% among Black Americans nationally, and significantly lower than the rate of 26% among whites in Florida.
- 21% of lung cancer cases are diagnosed at an early stage among Black Americans in Florida, significantly lower than the rate of 23% among Black Americans nationally, and significantly lower than the rate of 25% among whites in Florida.
- 15% of Black Americans with lung cancer in Florida underwent surgery, significantly lower than the rate of 17% among Black Americans nationally, and significantly lower than the rate of 20% among whites in Florida.
- 30% of Black Americans with lung cancer in Florida did not receive any treatment, significantly higher than the rate of 22% among Black Americans nationally, and significantly higher than the rate of 25% among whites in Florida.
Latino Americans:
- The rate of new lung cancer cases is 38 per 100,000 population among Latinos in Florida, significantly higher than the rate of 29 among Latinos nationally, and significantly lower than the rate of 63 among whites in Florida.
- State-level survival rates are not available for Latino Americans at this time. Nationally, the five-year survival rate among Latino Americans is 19%, 25% lower than among white Americans.
- 24% of lung cancer cases are diagnosed at an early stage among Latinos in Florida, significantly higher than the rate of 23% among Latinos nationally, and significantly lower than the rate of 25% among whites in Florida.
- 27% of Latinos with lung cancer in Florida underwent surgery, significantly higher than the rate of 22% among Latinos nationally, and significantly higher than the rate of 20% among whites in Florida.
- 26% of Latinos with lung cancer in Florida did not receive any treatment, not significantly different than the rate of 26% among Latinos nationally, and significantly higher than the rate of 25% among whites in Florida.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 25 per 100,000 population among Asian Americans or Pacific Islanders in Florida, significantly lower than the rate of 34 among Asian Americans or Pacific Islanders nationally, and significantly lower than the rate of 63 among whites in Florida.
- State-level survival rates are not available for Asian Americans or Pacific Islanders at this time. Nationally, the five-year survival rate among Asian Americans or Pacific Islanders is 23% and not significantly different than among white Americans.
- 20% of lung cancer cases are diagnosed at an early stage among Asian Americans or Pacific Islanders in Florida, not significantly different than the rate of 22% among Asian Americans or Pacific Islanders nationally, and significantly lower than the rate of 25% among whites in Florida.
- 23% of Asian Americans or Pacific Islanders with lung cancer in Florida underwent surgery, not significantly different than the rate of 25% among Asian Americans or Pacific Islanders nationally, and not significantly different than the rate of 20% among whites in Florida.
- 23% of Asian Americans or Pacific Islanders with lung cancer in Florida did not receive any treatment, not significantly different than the rate of 21% among Asian Americans or Pacific Islanders nationally, and not significantly different than the rate of 25% among whites in Florida.
Indigenous Peoples:
- The rate of new lung cancer cases is 23 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Florida, significantly lower than the rate of 41 among Indigenous Peoples nationally, and significantly lower than the rate of 63 among whites in Florida.
- State-level survival rates are not available for Indigenous Peoples at this time. Nationally, the five-year survival rate among Indigenous Peoples is 19% and not significantly different than among white Americans.
- 25% of lung cancer cases are diagnosed at an early stage among Indigenous Peoples (American Indians/Alaska Natives) in Florida, not significantly different than the rate of 23% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and not significantly different than the rate of 25% among whites in Florida.
- 22% of Indigenous Peoples (American Indians/Alaska Natives) with lung cancer in Florida underwent surgery, not significantly different than the rate of 17% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and not significantly different than the rate of 20% among whites in Florida.
- 18% of Indigenous Peoples (American Indians/Alaska Natives) with lung cancer in Florida did not receive any treatment, not significantly different than the rate of 22% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and not significantly different than the rate of 25% among whites in Florida.
Summary
Despite the early diagnosis rate in Florida falling into the average tier, the state still has a lot of work to do to make sure that more of those at high risk for lung cancer are screened.
Florida has improved access to expanded screening by covering it through its fee-for-service Medicaid program. The Lung Association encourages all states to cover lung cancer screening based on the latest guidelines across all fee-for-service and managed care plans without any financial or administrative barriers in their Medicaid programs.
It is alarming that Florida falls into the below average tier for percent of patients receiving no treatment. Some patients do refuse treatment, but issues such as fatalism and stigma can prevent eligible patients from accessing treatment that may save or extend their lives. All patients should work with their doctors to establish a treatment plan and goals.