Oklahoma
Fee-For-Service Medicaid Coverage of Screening
Covered and Using Updated Guidelines
Highlighted Disparity
Indigenous Peoples in Oklahoma are most likely to be diagnosed with lung cancer.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 63.5 and significantly higher than the national rate of 54.6.
- Oklahoma ranks 40th among all states, placing it in the below average tier.
- Over the last five years, the rate of new cases improved by 14%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Oklahoma is 21.2%, which is significantly lower than the national rate of 26.6%.
- It ranks 42nd among the 42 states with survival data, placing it in the bottom tier.
- Over the last five years, the survival rate in Oklahoma improved by 20%.
Early Diagnosis:
- 22.7% of cases are caught at an early stage, which is significantly lower than the national rate of 26.6%.
- It ranks 45th among the 47 states with data on diagnosis at an early stage, placing it in the bottom tier.
- Over the last five years, the early diagnosis rate in Oklahoma improved by 18%.
Lung Cancer Treatment
Surgical Treatment:
- Oklahoma ranked 45th (out of the 47 states with available data) with 15.5% 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 Oklahoma in the bottom tier.
- Over the last five years, the percent of cases undergoing surgery in Oklahoma did not change significantly.
Lack of Treatment:
- Oklahoma ranked 40th (out of the 47 states with available data) with 24.2% of cases not receiving any treatment.
- This is significantly higher than the national rate of 20.6% and puts Oklahoma in the below average tier.
- Over the last five years, the percent of cases receiving no treatment in Oklahoma increased by 19%.
Screening
Screening for High Risk:
- In Oklahoma, 1.7% of those at high risk were screened, which was significantly lower than the national rate of 4.5%.
- It ranks 45th among all states, placing it in the bottom tier.
- Actual screening rates may be higher in states with large, regional managed care providers that did not share screening data.
Medicaid Coverage:
- Oklahoma 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 Oklahoma is 16.9% and significantly higher than the national rate of 13.5%.
- It ranks 39th among all states, placing it in the below average tier.
Radon:
- In Oklahoma, 9.5% of radon tests results were at or above the action level recommended by EPA.
- It ranks 7th among all states, placing it in the above average tier.
Racial & Ethnic Disparities
Black individuals:
- The rate of new lung cancer cases is 63.3 per 100,000 population among Black individuals in Oklahoma, significantly higher than the rate of 56.3 among Black individuals nationally, and not significantly different than the rate of 63.3 among white individuals in Oklahoma.
- The five-year survival rate is 20.5% among Black individuals in Oklahoma, not significantly different than the rate of 23.8% among Black individuals nationally, and not significantly different than the rate of 21.4% among white individuals in Oklahoma.
- 20.5% of lung cancer cases are diagnosed at an early stage among Black individuals in Oklahoma, not significantly different than the rate of 23.2% among Black individuals nationally, and not significantly different than the rate of 23.0% among white individuals in Oklahoma.
- 13.8% of Black individuals with lung cancer in Oklahoma underwent surgery, significantly lower than the rate of 17.0% among Black individuals nationally, and significantly lower than the rate of 15.7% among white individuals in Oklahoma.
- 24.9% of Black individuals with lung cancer in Oklahoma 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 24.0% among white individuals in Oklahoma.
Latino individuals:
- The rate of new lung cancer cases is 32.4 per 100,000 population among Latino individuals in Oklahoma, not significantly different than the rate of 28.2 among Latino individuals nationally, and significantly lower than the rate of 63.3 among white individuals in Oklahoma.
- 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.
- 23.9% of lung cancer cases are diagnosed at an early stage among Latino individuals in Oklahoma, not significantly different than the rate of 23.1% among Latino individuals nationally, and not significantly different than the rate of 23.0% among white individuals in Oklahoma.
- 18.6% of Latino individuals with lung cancer in Oklahoma underwent surgery, not significantly different than the rate of 21.6% among Latino individuals nationally, and not significantly different than the rate of 15.7% among white individuals in Oklahoma.
- 22.0% of Latino individuals with lung cancer in Oklahoma 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 24.0% among white individuals in Oklahoma.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 39.1 per 100,000 population among Asian or Pacific Islanders individuals in Oklahoma, not significantly different than the rate of 32.9 among Asian or Pacific Islanders individuals nationally, and significantly lower than the rate of 63.3 among white individuals in Oklahoma.
- 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.
- 19.4% of Asian or Pacific Islander individuals with lung cancer in Oklahoma did not receive any treatment, not significantly different than the rate of 20.2% among Asian or Pacific Islander individuals nationally, and not significantly different than the rate of 24.0% among white individuals in Oklahoma.
- Other lung cancer rates are not available for Asian or Pacific Islander individuals in Oklahoma due to too few cases over the time period to allow for accurate analysis.
Indigenous Peoples:
- The rate of new lung cancer cases is 87.2 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Oklahoma, significantly higher than the rate of 39.4 among Indigenous Peoples nationally, and significantly higher than the rate of 63.3 among white individuals in Oklahoma.
- 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.
- 21.6% of lung cancer cases are diagnosed at an early stage among Indigenous Peoples (American Indians/Alaska Natives) in Oklahoma, 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 23.0% among white individuals in Oklahoma.
- 14.1% of Indigenous Peoples (American Indians/Alaska Natives) with lung cancer in Oklahoma underwent surgery, significantly lower than the rate of 16.3% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and not significantly different than the rate of 15.7% among white individuals in Oklahoma.
- 26.1% of Indigenous Peoples (American Indians/Alaska Natives) with lung cancer in Oklahoma did not receive any treatment, significantly higher than the rate of 23.2% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and not significantly different than the rate of 24.0% among white individuals in Oklahoma.
Summary
The early diagnosis rate in Oklahoma falls into the bottom 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.
Oklahoma 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.
It is alarming that Oklahoma falls into the below 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.