Iowa
Fee-For-Service Medicaid Coverage of Screening
Covered and Using Updated Guidelines
Highlighted Disparity
Black individuals in Iowa are most likely to be diagnosed with lung cancer.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 61.1 and significantly higher than the national rate of 54.6.
- Iowa ranks 37th among all states, placing it in the below average tier.
- Over the last five years, the rate of new cases in Iowa improved by 9%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Iowa is 24.8%, which is significantly lower than the national rate of 26.6%.
- It ranks 26th among the 42 states with survival data, placing it in the below average tier.
- Over the last five years, the survival rate in Iowa improved by 30%.
Early Diagnosis:
- 24.8% of cases are caught at an early stage, which is significantly lower than the national rate of 26.6%.
- It ranks 38th among the 47 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 Iowa improved by 40%.
Lung Cancer Treatment
Surgical Treatment:
- Iowa ranked 36th (out of the 47 states with available data) with 17.6% of cases undergoing surgery as part of the first course of treatment.
- This is significantly lower than the national rate of 20.8% and puts Iowa in the below average tier.
- Over the last five years, the percent of cases undergoing surgery in Iowa did not change significantly.
Lack of Treatment:
- Iowa ranked 15th (out of the 47 states with available data) with 18.2% of cases not receiving any treatment.
- This is significantly lower than the national rate of 20.6% and puts Iowa in the above average tier.
- Over the last five years, the percent of cases receiving no treatment in Iowa did not change significantly.
Screening
Screening for High Risk:
- In Iowa, 7.1% of those at high risk were screened, which was significantly higher than the national rate of 4.5%.
- It ranks 11th 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:
- Iowa was one of the 49 states whose Medicaid fee-for-service programs covered lung cancer screening as of October 2023.
- However, their program did not use recommended guidelines for determining eligibility, and also required prior authorization and copays.
Prevention
Tobacco Use:
- The smoking rate in Iowa is 14.6% and not significantly than the national rate of 13.5%.
- It ranks 28th among all states, placing it in the average tier.
Radon:
- In Iowa, 57.9% of radon tests results were at or above the action level recommended by EPA.
- It ranks 49th among all states, placing it in the bottom tier.
Racial & Ethnic Disparities
Black individuals:
- The rate of new lung cancer cases is 81.6 per 100,000 population among Black individuals in Iowa, significantly higher than the rate of 56.3 among Black individuals nationally, and significantly higher than the rate of 61.8 among white individuals in Iowa.
- The five-year survival rate is 20.6% among Black individuals in Iowa, not significantly different than the rate of 23.8% among Black individuals nationally, and not significantly different than the rate of 25.0% among white individuals in Iowa.
- 21.1% of lung cancer cases are diagnosed at an early stage among Black individuals in Iowa, not significantly different than the rate of 23.2% among Black individuals nationally, and not significantly different than the rate of 24.9% among white individuals in Iowa.
- 12.4% of Black individuals with lung cancer in Iowa underwent surgery, significantly lower than the rate of 17.0% among Black individuals nationally, and significantly lower than the rate of 17.6% among white individuals in Iowa.
- 18.2% of Black individuals with lung cancer in Iowa 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 18.3% among white individuals in Iowa.
Latino individuals:
- The rate of new lung cancer cases is 26.0 per 100,000 population among Latino individuals in Iowa, 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 Iowa.
- 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.
- 22.1% of lung cancer cases are diagnosed at an early stage among Latino individuals in Iowa, not significantly different than the rate of 23.1% among Latino individuals nationally, and not significantly different than the rate of 24.9% among white individuals in Iowa.
- Other lung cancer rates are not available for Latino individuals in Iowa 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 37.2 per 100,000 population among Asian or Pacific Islanders individuals in Iowa, not significantly different 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 Iowa.
- 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 Iowa due to too few cases over the time period to allow for accurate analysis.
Indigenous Peoples:
- The rate of new lung cancer cases is 46.9 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Iowa, not significantly different than the rate of 39.4 among Indigenous Peoples nationally, and not significantly different than the rate of 61.8 among white individuals in Iowa.
- State-level survival rates are not available for Indigenous Peoples at this time. Nationally, the five-year survival rate among Indigenous Peoples is 22.3% and not significantly different than the rate of 25.0% among white individuals.
- Other lung cancer rates are not available for Indigenous Peoples (American Indians/Alaska Natives) in Iowa due to too few cases over the time period to allow for accurate analysis.
Summary
The early diagnosis rate in Iowa 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.
Iowa 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.
Iowa falls into the above 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.