Nebraska
Fee-For-Service Medicaid Coverage of Screening
Covered
Highlighted Disparity
Black individuals in Nebraska are least likely to receive surgical treatment.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 52.8 and significantly lower than the national rate of 54.6.
- Nebraska ranks 17th among all states, placing it in the average tier.
- Over the last five years, the rate of new cases in Nebraska improved by 19%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Nebraska is 24.5%, which is significantly lower than the national rate of 26.6%.
- It ranks 28th among the 42 states with survival data, placing it in the below average tier.
- Over the last five years, the survival rate in Nebraska improved by 19%.
Early Diagnosis:
- 28.5% of cases are caught at an early stage, which is not significantly different than the national rate of 26.6%.
- It ranks 9th 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 Nebraska did not change significantly.
Lung Cancer Treatment
Surgical Treatment:
- Nebraska ranked 12th (out of the 47 states with available data) with 22.2% of cases undergoing surgery as part of the first course of treatment.
- This is not significantly than the national rate of 20.8% and puts Nebraska in the average tier.
- Over the last five years, the percent of cases undergoing surgery in Nebraska did not change significantly.
Lack of Treatment:
- Nebraska ranked 22nd (out of the 47 states with available data) with 19.1% of cases not receiving any treatment.
- This is significantly lower than the national rate of 20.6% and puts Nebraska in the above average tier.
- Over the last five years, the percent of cases receiving no treatment in Nebraska did not change significantly.
Screening
Screening for High Risk:
- In Nebraska, 3.7% of those at high risk were screened, which is significantly lower than the national rate of 4.5%.
- It ranks 33rd among all states, placing it in the below average tier.
- Actual screening rates may be higher in states with large, regional managed care providers that did not share screening data.
Medicaid Coverage:
- Nebraska 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 copays, it did not use recommended guidelines for determining eligibility and required prior authorization.
Prevention
Tobacco Use:
- The smoking rate in Nebraska is 13.4% and not significantly different than the national rate of 13.5%.
- It ranks 22nd among all states, placing it in the average tier.
Radon:
- In Nebraska, 55.8% of radon tests results were at or above the action level recommended by EPA.
- It ranks 48th among all states, placing it in the bottom tier.
Racial & Ethnic Disparities
Black individuals:
- The rate of new lung cancer cases is 67.6 per 100,000 population among Black individuals in Nebraska, significantly higher than the rate of 56.3 among Black individuals nationally, and significantly higher than the rate of 53.3 among white individuals in Nebraska.
- The five-year survival rate is 25.0% among Black individuals in Nebraska, not significantly different than the rate of 23.8% among Black individuals nationally, and not significantly different than the rate of 24.3% among white individuals in Nebraska.
- 26.5% of lung cancer cases are diagnosed at an early stage among Black individuals in Nebraska, not significantly different than the rate of 23.2% among Black individuals nationally, and not significantly different than the rate of 28.7% among white individuals in Nebraska.
- 15.1% of Black individuals with lung cancer in Nebraska underwent surgery, not significantly different than the rate of 17.0% among Black individuals nationally, and significantly lower than the rate of 22.6% among white individuals in Nebraska.
- 19.2% of Black individuals with lung cancer in Nebraska 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 19.0% among white individuals in Nebraska.
Latino individuals:
- The rate of new lung cancer cases is 31.7 per 100,000 population among Latino individuals in Nebraska, not significantly different than the rate of 28.2 among Latino individuals nationally, and significantly lower than the rate of 53.3 among white individuals in Nebraska.
- 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.
- 26.9% of lung cancer cases are diagnosed at an early stage among Latino individuals in Nebraska, not significantly different than the rate of 23.1% among Latino individuals nationally, and not significantly different than the rate of 28.7% among white individuals in Nebraska.
- 22.3% of Latino individuals with lung cancer in Nebraska underwent surgery, not significantly different than the rate of 21.6% among Latino individuals nationally, and not significantly different than the rate of 22.6% among white individuals in Nebraska.
- 23.1% of Latino individuals with lung cancer in Nebraska did not receive any treatment, not significantly different than the rate of 26.1% among Latino individuals nationally, and not significantly different than the rate of 19.0% among white individuals in Nebraska.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 34.0 per 100,000 population among Asian or Pacific Islanders individuals in Nebraska, not significantly different than the rate of 32.9 among Asian or Pacific Islanders individuals nationally, and significantly lower than the rate of 53.3 among white individuals in Nebraska.
- 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 Nebraska due to too few cases over the time period to allow for accurate analysis.
Indigenous Peoples:
- The rate of new lung cancer cases is 57.8 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Nebraska, not significantly different than the rate of 39.4 among Indigenous Peoples nationally, and not significantly different than the rate of 53.3 among white individuals in Nebraska.
- 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 Nebraska due to too few cases over the time period to allow for accurate analysis.
Summary
Despite the early diagnosis rate in Nebraska 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.
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.
Nebraska 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.