Massachusetts
Fee-For-Service Medicaid Coverage of Screening
Covered
Highlighted Disparity
Asian or Pacific Islander individuals in Massachusetts are least likely to be diagnosed early.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 59.5 and significantly higher than the national rate of 54.6.
- Massachusetts ranks 31st among all states, placing it in the average tier.
- Over the last five years, the rate of new cases improved by 15%.
5-Year Survival Rate:
- The percent of people still alive five years after being diagnosed with lung cancer (the survival rate) is 26.6% nationally.
- Massachusetts is one of the 9 states for which survival data is not available as they do not track cases after diagnosis.
Early Diagnosis:
- 33.3% of cases are caught at an early stage, which is significantly higher than the national rate of 26.6%.
- It ranks 1st among the 47 states with data on diagnosis at an early stage, placing it in the top tier.
- Over the last five years, the early diagnosis rate in Massachusetts improved by 9%.
Lung Cancer Treatment
Surgical Treatment:
- Massachusetts ranked 1st (out of the 47 states with available data) with 31.3% of cases undergoing surgery as part of the first course of treatment.
- This is significantly higher than the national rate of 20.8% and puts Massachusetts in the top tier.
- Over the last five years, the percent of cases undergoing surgery in Massachusetts did not change significantly.
Lack of Treatment:
- Massachusetts ranked 2nd (out of the 47 states with available data) with 13.4% of cases not receiving any treatment.
- This is significantly lower than the national rate of 20.6% and puts Massachusetts in the top tier.
- Over the last five years, the percent of cases receiving no treatment in Massachusetts improved by 13%.
Screening
Screening for High Risk:
- In Massachusetts, 11.9% of those at high risk were screened, which was significantly higher than the national rate of 4.5%.
- It ranks 1st among all states, placing it in the top tier.
- Actual screening rates may be higher in states with large, regional managed care providers that did not share screening data.
Medicaid Coverage:
- Massachusetts was one of the 49 states whose Medicaid fee-for-service programs covered lung cancer screening as of October 2023.
- While their program did not require prior authorization or copays, it did not use recommended guidelines for determining eligibility.
Prevention
Tobacco Use:
- The smoking rate in Massachusetts is 10.6% and significantly lower than the national rate of 13.5%.
- It ranks 6th among all states, placing it in the above average tier.
Radon:
- In Massachusetts, 21.8% of radon tests results were at or above the action level recommended by EPA.
- It ranks 25th among all states, placing it in the average tier.
Racial & Ethnic Disparities
Black individuals:
- The rate of new lung cancer cases is 44.7 per 100,000 population among Black individuals in Massachusetts, significantly lower than the rate of 56.3 among Black individuals nationally, and significantly lower than the rate of 62.7 among white individuals in Massachusetts.
- Survival rates by race and ethnicity are not available for Massachusetts at this time. Nationally, the five-year survival rate among Black individuals is 23.8%, 11% lower than among white Americans.
- 30.0% of lung cancer cases are diagnosed at an early stage among Black individuals in Massachusetts, significantly higher than the rate of 23.2% among Black individuals nationally, and significantly lower than the rate of 33.7% among white individuals in Massachusetts.
- 27.7% of Black individuals with lung cancer in Massachusetts underwent surgery, significantly higher than the rate of 17.0% among Black individuals nationally, and not significantly different than the rate of 31.3% among white individuals in Massachusetts.
- 14.2% of Black individuals with lung cancer in Massachusetts did not receive any treatment, significantly lower than the rate of 22.4% among Black individuals nationally, and not significantly different than the rate of 13.5% among white individuals in Massachusetts.
Latino individuals:
- The rate of new lung cancer cases is 32.8 per 100,000 population among Latino individuals in Massachusetts, significantly higher than the rate of 28.2 among Latino individuals nationally, and significantly lower than the rate of 62.7 among white individuals in Massachusetts.
- 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.
- 32.9% of lung cancer cases are diagnosed at an early stage among Latino individuals in Massachusetts, significantly higher than the rate of 23.1% among Latino individuals nationally, and not significantly different than the rate of
- 33.7% among white individuals in Massachusetts. 32.4% of Latino individuals with lung cancer in Massachusetts underwent surgery, significantly higher than the rate of 21.6% among Latino individuals nationally, and not significantly different than the rate of 31.3% among white individuals in Massachusetts.
- 13.3% of Latino individuals with lung cancer in Massachusetts did not receive any treatment, significantly lower than the rate of 26.1% among Latino individuals nationally, and not significantly different than the rate of 13.5% among white individuals in Massachusetts.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 37.5 per 100,000 population among Asian or Pacific Islanders individuals in Massachusetts, significantly higher than the rate of 32.9 among Asian or Pacific Islanders individuals nationally, and significantly lower than the rate of 62.7 among white individuals in Massachusetts.
- 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.
- 24.4% of lung cancer cases are diagnosed at an early stage among Asian or Pacific Islander individuals in Massachusetts, not significantly different than the rate of 22.8% among Asian or Pacific Islander individuals nationally, and significantly lower than the rate of 33.7% among white individuals in Massachusetts.
- 31.3% of Asian or Pacific Islander individuals with lung cancer in Massachusetts underwent surgery, significantly higher than the rate of 24.7% among Asian or Pacific Islander individuals nationally, and not significantly different than the rate of 31.3% among white individuals in Massachusetts.
- 12.2% of Asian or Pacific Islander individuals with lung cancer in Massachusetts did not receive any treatment, significantly lower than the rate of 20.2% among Asian or Pacific Islander individuals nationally, and not significantly different than the rate of 13.5% among white individuals in Massachusetts.
Indigenous Peoples:
- The rate of new lung cancer cases is 22.6 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Massachusetts, significantly lower than the rate of 39.4 among Indigenous Peoples nationally, and significantly lower than the rate of 62.7 among white individuals in Massachusetts.
- 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 Massachusetts due to too few cases over the time period to allow for accurate analysis.
Summary
Despite the early diagnosis rate in Massachusetts falling into the top 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.
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.
Massachusetts falls into the top 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.