Delaware
Fee-For-Service Medicaid Coverage of Screening
Covered and Using Updated Guidelines
Highlighted Disparity
Black individuals in Delaware are least likely to be diagnosed early.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 57.4 and significantly higher than the national rate of 54.6.
- Delaware ranks 27th among all states, placing it in the average tier.
- Over the last five years, the rate of new cases improved by 32%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Delaware is 28.3%, which is not significantly different than the national rate of 26.6%
- It ranks 12th among the 42 states with survival data, placing it in the average tier.
- Over the last five years, the survival rate in Delaware improved by 31%.
Early Diagnosis:
- 28.4% of cases are caught at an early stage, which is significantly higher than the national rate of 26.6%.
- It ranks 10th among the 47 states with data on diagnosis at an early stage, placing it in the above average tier.
- Over the last five years, the early diagnosis rate in Delaware did not change significantly.
Lung Cancer Treatment
Surgical Treatment:
- Delaware ranked 17th (out of the 47 states with available data) with 21.3% of cases undergoing surgery as part of the first course of treatment.
- This is not significantly different than the national rate of 20.8% and puts Delaware in the average tier.
- Over the last five years, the percent of cases undergoing surgery in Delaware improved by 32% .
Lack of Treatment:
- Delaware ranked 25th (out of the 47 states with available data) with 19.6% of cases not receiving any treatment.
- This is not significantly different than the national rate of 20.6% and puts Delaware in the above average tier.
- Over the last five years, the percent of cases receiving no treatment in Delaware did not change significantly.
Screening
Screening for High Risk:
- In Delaware, 6.3% of those at high risk were screened, which was significantly higher than the national rate of 4.5%.
- It ranks 18th among all states, placing it in the above average tier.
- Actual screening rates may be higher in states with large, regional managed care providers that did not share screening data.
Medicaid Coverage:
- Delaware was one of the 49 states whose Medicaid fee-for-service programs covered lung cancer screening as of October 2023.
- In addition, their program used recommended guidelines for determining eligibility and did not require prior authorization or copays.
Prevention
Tobacco Use:
- The smoking rate in Delaware is 13.4% and not significantly different than the national rate of 13.5%.
- It ranks 23rd among all states, placing it in the average tier.
Radon:
- In Delaware, 15.4% of radon tests results were at or above the action level recommended by EPA.
- It ranks 17th among all states, placing it in the above average tier.
Racial & Ethnic Disparities
Black individuals:
- The rate of new lung cancer cases is 50.4 per 100,000 population among Black individuals in Delaware, significantly lower than the rate of 56.3 among Black individuals nationally, and significantly lower than the rate of 61.8 among white individuals in Delaware.
- The five-year survival rate is 24.8% among Black individuals in Delaware, not significantly different than the rate of 23.8% among Black individuals nationally, and not significantly different than the rate of 29.3% among white individuals in Delaware.
- 23.3% of lung cancer cases are diagnosed at an early stage among Black individuals in Delaware, not significantly different than the rate of 23.2% among Black individuals nationally, and significantly lower than the rate of 29.3% among white individuals in Delaware.
- 18.6% of Black individuals with lung cancer in Delaware underwent surgery, not significantly different than the rate of 17.0% among Black individuals nationally, and not significantly different than the rate of 21.7% among white individuals in Delaware.
- 22.1% of Black individuals with lung cancer in Delaware did not receive any treatment, not significantly different than the rate of 22.4% among Black individuals nationally, and not significantly different than the rate of 19.2% among white individuals in Delaware.
Latino individuals:
- The rate of new lung cancer cases is 26.6 per 100,000 population among Latino individuals in Delaware, not significantly different than the rate of 28.2 among Latino individuals nationally, and significantly lower than the rate of 61.8 among white individuals in Delaware.
- State-level survival rates are not available for Latino individuals at this time. Nationally, the five-year survival rate among Latino individuals is 22.7%, not significantly different than the rate of 25.0% among white individuals.
- 38.6% of lung cancer cases are diagnosed at an early stage among Latino individuals in Delaware, significantly higher than the rate of 23.1% among Latino individuals nationally, and not significantly different than the rate of 29.3% among white individuals in Delaware.
- Other lung cancer rates are not available for Latino individuals in Delaware due to too few cases over the time period to allow for accurate analysis.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 21.1 per 100,000 population among Asian or Pacific Islanders individuals in Delaware, significantly lower than the rate of 32.9 among Asian or Pacific Islanders individuals nationally, and significantly lower than the rate of 61.8 among white individuals in Delaware.
- State-level survival rates are not available for Asian or Pacific Islander individuals at this time. Nationally, the five-year survival rate among Asian or Pacific Islander individuals is 28.6% and significantly higher than the rate of 25.0% among white individuals.
- Other lung cancer rates are not available for Asian or Pacific Islander individuals in Delaware due to too few cases over the time period to allow for accurate analysis.
Indigenous Peoples:
- Lung cancer rates are not available for Indigenous Peoples (American Indians/Alaska Natives) in Delaware due to too few cases over the time period to allow for accurate analysis.
Summary
Despite the early diagnosis rate in Delaware falling into the above 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.
Delaware 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.
Delaware falls into the 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.