Pennsylvania
Fee-For-Service Medicaid Coverage of Screening
Covered
Highlighted Disparity
Asian or Pacific Islander individuals in Pennsylvania are least likely to be diagnosed early.
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.
- Pennsylvania ranks 33rd among all states, placing it in the average tier.
- Over the last five years, the rate of new cases improved by 20%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Pennsylvania is 28.8%, which is significantly higher than the national rate of 26.6%.
- It ranks 10th among the 42 states with survival data, placing it in the above average tier.
- Over the last five years, the survival rate in Pennsylvania improved by 27%.
Early Diagnosis:
- 27.3% of cases are caught at an early stage, which is significantly higher than the national rate of 26.6%.
- It ranks 20th among the 47 states with data on diagnosis at an early stage, placing it in the average tier.
- Over the last five years, the early diagnosis rate in Pennsylvania improved by 10%.
Lung Cancer Treatment
Surgical Treatment:
- Pennsylvania ranked 11th (out of the 47 states with available data) with 22.5% 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 Pennsylvania in the average tier.
- Over the last five years, the percent of cases undergoing surgery in Pennsylvania improved by -6%.
Lack of Treatment:
- Pennsylvania ranked 7th (out of the 47 states with available data) with 16.7% of cases not receiving any treatment.
- This is significantly lower than the national rate of 20.6% and puts Pennsylvania in the above average tier.
- Over the last five years, the percent of cases receiving no treatment in Pennsylvania improved by 16%.
Screening
Screening for High Risk:
- In Pennsylvania, 7.4% of those at high risk were screened, which was significantly higher than the national rate of 4.5%.
- It ranks 8th 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:
- Pennsylvania 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, it was not known if it used recommended guidelines for determining eligibility or required copays.
Prevention
Tobacco Use:
- The smoking rate in Pennsylvania is 14.4% and not significantly different than the national rate of 13.5%.
- It ranks 27th among all states, placing it in the average tier.
Radon:
- In Pennsylvania, 39.1% of radon tests results were at or above the action level recommended by EPA.
- It ranks 39th among all states, placing it in the below average tier.
Racial & Ethnic Disparities
Black individuals:
- The rate of new lung cancer cases is 69.6 per 100,000 population among Black individuals in Pennsylvania, significantly higher than the rate of 56.3 among Black individuals nationally, and significantly higher than the rate of 60.4 among white individuals in Pennsylvania.
- The five-year survival rate is 29.5% among Black individuals in Pennsylvania, significantly higher than the rate of 23.8% among Black individuals nationally, and not significantly different than the rate of 28.4% among white individuals in Pennsylvania.
- 27.6% of lung cancer cases are diagnosed at an early stage among Black individuals in Pennsylvania, significantly higher than the rate of 23.2% among Black individuals nationally, and not significantly different than the rate of 27.4% among white individuals in Pennsylvania.
- 20.8% of Black individuals with lung cancer in Pennsylvania underwent surgery, significantly higher than the rate of 17.0% among Black individuals nationally, and significantly lower than the rate of 22.7% among white individuals in Pennsylvania.
- 18.5% of Black individuals with lung cancer in Pennsylvania did not receive any treatment, significantly lower than the rate of 22.4% among Black individuals nationally, and significantly higher than the rate of 16.6% among white individuals in Pennsylvania.
Latino individuals:
- The rate of new lung cancer cases is 37.1 per 100,000 population among Latino individuals in Pennsylvania, significantly higher than the rate of 28.2 among Latino individuals nationally, and significantly lower than the rate of 60.4 among white individuals in Pennsylvania. 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.
- 25.1% of lung cancer cases are diagnosed at an early stage among Latino individuals in Pennsylvania, not significantly different than the rate of 23.1% among Latino individuals nationally, and not significantly different than the rate of 27.4% among white individuals in Pennsylvania.
- 23.8% of Latino individuals with lung cancer in Pennsylvania underwent surgery, significantly higher than the rate of 21.6% among Latino individuals nationally, and not significantly different than the rate of 22.7% among white individuals in Pennsylvania.
- 17.4% of Latino individuals with lung cancer in Pennsylvania 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 16.6% among white individuals in Pennsylvania.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 32.9 per 100,000 population among Asian or Pacific Islanders individuals in Pennsylvania, not significantly different than the rate of 32.9 among Asian or Pacific Islanders individuals nationally, and significantly lower than the rate of 60.4 among white individuals in Pennsylvania.
- 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.
- 20.9% of lung cancer cases are diagnosed at an early stage among Asian or Pacific Islander individuals in Pennsylvania, not significantly different than the rate of 22.8% among Asian or Pacific Islander individuals nationally, and significantly lower than the rate of 27.4% among white individuals in Pennsylvania.
- 22.7% of Asian or Pacific Islander individuals with lung cancer in Pennsylvania 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 22.7% among white individuals in Pennsylvania.
- 14.1% of Asian or Pacific Islander individuals with lung cancer in Pennsylvania 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 16.6% among white individuals in Pennsylvania.
Indigenous Peoples:
- The rate of new lung cancer cases is 26.0 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Pennsylvania, significantly lower than the rate of 39.4 among Indigenous Peoples nationally, and significantly lower than the rate of 60.4 among white individuals in Pennsylvania.
- 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 Pennsylvania due to too few cases over the time period to allow for accurate analysis.
Summary
Despite the early diagnosis rate in Pennsylvania falling into the 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.
Pennsylvania 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.