Michigan
Fee-For-Service Medicaid Coverage of Screening
Covered and Using Updated Guidelines
Highlighted Disparity
Indigenous Peoples in Michigan are most likely to be diagnosed with lung cancer.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 60.0 and significantly higher than the national rate of 54.6.
- Michigan ranks 34th among all states, placing it in the average tier.
- Over the last five years, the rate of new cases improved by 19%.
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.
- Michigan is one of the 9 states for which survival data is not available as they do not track cases after diagnosis.
Early Diagnosis:
- 24.6% of cases are caught at an early stage, which is significantly lower than the national rate of 26.6%.
- It ranks 41st 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 Michigan improved by 11%.
Lung Cancer Treatment
Surgical Treatment:
- Michigan ranked 29th (out of the 47 states with available data) with 19.0% 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 Michigan in the below average tier.
- Over the last five years, the percent of cases undergoing surgery in Michigan improved by -13%.
Lack of Treatment:
- Michigan ranked 19th (out of the 47 states with available data) with 18.5% of cases not receiving any treatment.
- This is significantly lower than the national rate of 20.6% and puts Michigan in the above average tier.
- Over the last five years, the percent of cases receiving no treatment in Michigan increased by 8%.
Screening
Screening for High Risk:
- In Michigan, 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:
- Michigan 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 Michigan is 17.0% and significantly higher than the national rate of 13.5%.
- It ranks 40th among all states, placing it in the below average tier.
Radon:
- In Michigan, 22.8% of radon tests results were at or above the action level recommended by EPA.
- It ranks 26th among all states, placing it in the average tier.
Racial & Ethnic Disparities
Black individuals:
- The rate of new lung cancer cases is 63.9 per 100,000 population among Black individuals in Michigan, significantly higher than the rate of 56.3 among Black individuals nationally, and significantly higher than the rate of 60.6 among white individuals in Michigan.
- Survival rates by race and ethnicity are not available for Michigan at this time. Nationally, the five-year survival rate among Black individuals is 23.8%, 11% lower than among white Americans.
- 21.4% of lung cancer cases are diagnosed at an early stage among Black individuals in Michigan, significantly lower than the rate of 23.2% among Black individuals nationally, and significantly lower than the rate of 25.2% among white individuals in Michigan.
- 15.1% of Black individuals with lung cancer in Michigan underwent surgery, significantly lower than the rate of 17.0% among Black individuals nationally, and significantly lower than the rate of 19.5% among white individuals in Michigan.
- 24.1% of Black individuals with lung cancer in Michigan did not receive any treatment, significantly higher than the rate of 22.4% among Black individuals nationally, and significantly higher than the rate of 17.7% among white individuals in Michigan.
Latino individuals:
- The rate of new lung cancer cases is 31.6 per 100,000 population among Latino individuals in Michigan, not significantly different than the rate of 28.2 among Latino individuals nationally, and significantly lower than the rate of 60.6 among white individuals in Michigan.
- 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 Michigan, not significantly different than the rate of 23.1% among Latino individuals nationally, and not significantly different than the rate of 25.2% among white individuals in Michigan.
- 20.0% of Latino individuals with lung cancer in Michigan underwent surgery, not significantly different than the rate of 21.6% among Latino individuals nationally, and not significantly different than the rate of 19.5% among white individuals in Michigan.
- 19.6% of Latino individuals with lung cancer in Michigan 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 17.7% among white individuals in Michigan.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 27.0 per 100,000 population among Asian or Pacific Islanders individuals in Michigan, significantly lower than the rate of 32.9 among Asian or Pacific Islanders individuals nationally, and significantly lower than the rate of 60.6 among white individuals in Michigan.
- 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.
- 19.6% of lung cancer cases are diagnosed at an early stage among Asian or Pacific Islander individuals in Michigan, not significantly different than the rate of 22.8% among Asian or Pacific Islander individuals nationally, and significantly lower than the rate of 25.2% among white individuals in Michigan.
- 21.5% of Asian or Pacific Islander individuals with lung cancer in Michigan underwent surgery, not significantly different than the rate of 24.7% among Asian or Pacific Islander individuals nationally, and not significantly different than the rate of 19.5% among white individuals in Michigan.
- 15.2% of Asian or Pacific Islander individuals with lung cancer in Michigan 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 17.7% among white individuals in Michigan.
Indigenous Peoples:
- The rate of new lung cancer cases is 92.3 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Michigan, significantly higher than the rate of 39.4 among Indigenous Peoples nationally, and significantly higher than the rate of 60.6 among white individuals in Michigan.
- 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.
- 21.5% of lung cancer cases are diagnosed at an early stage among Indigenous Peoples (American Indians/Alaska Natives) in Michigan, not significantly different than the rate of 23.5% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and not significantly different than the rate of 25.2% among white individuals in Michigan.
- 15.4% of Indigenous Peoples (American Indians/Alaska Natives) with lung cancer in Michigan underwent surgery, not significantly different than the rate of 16.3% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and significantly lower than the rate of 19.5% among white individuals in Michigan.
- 23.4% of Indigenous Peoples (American Indians/Alaska Natives) with lung cancer in Michigan did not receive any treatment, not significantly different than the rate of 23.2% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and significantly higher than the rate of 17.7% among white individuals in Michigan.
Summary
The early diagnosis rate in Michigan 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.
Michigan 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.
Michigan 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.