Oklahoma
Fee-For-Service Medicaid Coverage of Screening
Covered and Using Updated Guidelines
Highlighted Disparity
Indigenous Peoples in Oklahoma are most likely to be diagnosed with lung cancer.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 66 and significantly higher than the national rate of 57.
- Oklahoma ranks 41st among all states, placing it in the below average tier.
- Over the last five years, the rate of new cases improved by 6%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Oklahoma is 20%, which is significantly lower than the national rate of 25%.
- It ranks 46th among the 45 states with survival data, placing it in the bottom tier.
- Over the last five years, the survival rate in Oklahoma improved by 14% .
Early Diagnosis:
- 22% of cases are caught at an early stage, which is significantly lower than the national rate of 26%.
- It ranks 47th among the 49 states with data on diagnosis at an early stage, placing it in the below average tier.
- Over the last five years, the early diagnosis rate in Oklahoma improved by 13%.
Lung Cancer Treatment
Surgical Treatment:
- Oklahoma ranked 47th (out of the 49 states with available data) with 16% of cases undergoing surgery as part of the first course of treatment.
- This is significantly lower than the national rate of 21% and puts Oklahoma in the bottom tier.
- Over the last five years, the percent of cases undergoing surgery in Oklahoma did not change significantly.
Lack of Treatment:
- Oklahoma ranked 41st (out of the 49 states with available data) with 23% of cases not receiving any treatment.
- This is significantly higher than the national rate of 21% and puts Oklahoma in the below average tier.
- Over the last five years, the percent of cases receiving no treatment in Oklahoma did not change significantly.
Screening
Screening for High Risk:
- In Oklahoma, 2% of those at high risk were screened, which was significantly lower than the national rate of 6%.
- It ranks 45th among all states, placing it in the bottom tier.
- Screening rates may be higher in states with large, regional managed care providers that did not share screening data.
Medicaid Coverage:
- Oklahoma 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 and did not require copays, it did require prior authorization.
Prevention
Tobacco Use:
- The smoking rate in Oklahoma is 19% and significantly higher than the national rate of 14%.
- It ranks 44th among all states, placing it in the below average tier.
Radon:
- In Oklahoma, 10% of radon tests results were at or above the action level recommended by EPA.
- It ranks 7th among all states, placing it in the above average tier.
Racial & Ethnic Disparities
Black Americans:
- The rate of new lung cancer cases is 65 per 100,000 population among Black Americans in Oklahoma, significantly higher than the rate of 59 among Black Americans nationally, and not significantly different than the rate of 66 among whites in Oklahoma.
- The five-year survival rate is 18% among Black Americans in Oklahoma, not significantly different than the rate of 22% among Black Americans nationally, and not significantly different than the rate of 20% among whites in Oklahoma.
- 18% of lung cancer cases are diagnosed at an early stage among Black Americans in Oklahoma, significantly lower than the rate of 23% among Black Americans nationally, and significantly lower than the rate of 23% among whites in Oklahoma.
- 14% of Black Americans with lung cancer in Oklahoma underwent surgery, significantly lower than the rate of 17% among Black Americans nationally, and significantly lower than the rate of 16% among whites in Oklahoma.
- 24% of Black Americans with lung cancer in Oklahoma did not receive any treatment, not significantly different than the rate of 22% among Black Americans nationally, and not significantly different than the rate of 23% among whites in Oklahoma.
Latino Americans:
- The rate of new lung cancer cases is 33 per 100,000 population among Latinos in Oklahoma, not significantly different than the rate of 29 among Latinos nationally, and significantly lower than the rate of 66 among whites in Oklahoma.
- 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.
- 22% of lung cancer cases are diagnosed at an early stage among Latinos in Oklahoma, not significantly different than the rate of 23% among Latinos nationally, and not significantly different than the rate of 23% among whites in Oklahoma.
- 18% of Latinos with lung cancer in Oklahoma underwent surgery, not significantly different than the rate of 22% among Latinos nationally, and not significantly different than the rate of 16% among whites in Oklahoma.
- 20% of Latinos with lung cancer in Oklahoma did not receive any treatment, significantly lower than the rate of 26% among Latinos nationally, and not significantly different than the rate of 23% among whites in Oklahoma.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 39 per 100,000 population among Asian Americans or Pacific Islanders in Oklahoma, not significantly different than the rate of 34 among Asian Americans or Pacific Islanders nationally, and significantly lower than the rate of 66 among whites in Oklahoma.
- 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.
- 16% of Asian Americans or Pacific Islanders with lung cancer in Oklahoma did not receive any treatment, not significantly different than the rate of 21% among Asian Americans or Pacific Islanders nationally, and significantly lower than the rate of 23% among whites in Oklahoma.
- Other lung cancer rates are not available for Asian Americans or Pacific Islanders in Oklahoma due to too few cases over the time period to allow for accurate analysis.
Indigenous Peoples:
- The rate of new lung cancer cases is 92 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Oklahoma, significantly higher than the rate of 41 among Indigenous Peoples nationally, and significantly higher than the rate of 66 among whites in Oklahoma.
- 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.
- 21% of lung cancer cases are diagnosed at an early stage among Indigenous Peoples (American Indians/Alaska Natives) in Oklahoma, not significantly different than the rate of 23% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and not significantly different than the rate of 23% among whites in Oklahoma.
- 15% of Indigenous Peoples (American Indians/Alaska Natives) with lung cancer in Oklahoma 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 16% among whites in Oklahoma.
- 24% of Indigenous Peoples (American Indians/Alaska Natives) with lung cancer in Oklahoma 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 23% among whites in Oklahoma.
Summary
The early diagnosis rate in Oklahoma falls into the below 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.
Oklahoma 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 Oklahoma 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.