Delaware
Fee-For-Service Medicaid Coverage of Screening
Yes
Highlighted Disparity
No racial disparities were found in Delaware for these lung cancer metrics.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 65 and significantly higher than the national rate of 58.
- Delaware ranks 39th among all states, placing it in the below average tier.
- Over the last five years, the rate of new cases improved by 15%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Delaware is 24%, which is not significantly different than the national rate of 24%
- It ranks 19th among the 45 states with survival data, placing it in the average tier.
- Over the last five years, the survival rate in Delaware improved by 28%.
Early Diagnosis:
- 27% of cases are caught at an early stage, which is significantly higher than the national rate of 24%.
- It ranks 7th among the 49 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 Delaware did not change significantly.
Lung Cancer Treatment
Surgical Treatment:
- Delaware ranked 30th (out of the 49 states with available data) with 19% of cases undergoing surgery as part of the first course of treatment.
- This is significantly lower than the national rate of 20.7% and puts Delaware in the below average tier.
- Over the last five years, the percent of cases undergoing surgery in Delaware did not change significantly.
Lack of Treatment:
- Delaware ranked 22nd (out of the 49 states with available data) with 19% of cases not receiving any treatment.
- This is significantly lower than the national rate of 21% and puts Delaware in the above average tier.
- Over the last five years, the percent of cases receiving no treatment in Delaware did not change significantly.
Screening
Screening for High Risk:
- In Delaware, 9% of those at high risk were screened, which was significantly higher than the national rate of 6%.
- It ranks 10th among all states, placing it in the above average tier.
Medicaid Coverage:
- Delaware was one of the 40 states whose Medicaid fee-for-service programs covered lung cancer screening as of September 2021.
- While their program used recommended guidelines for determining eligibility and did not require cost sharing, it did require prior authorization.
Prevention
Tobacco Use:
- The smoking rate in Delaware is 16% and not significantly different than the national rate of 15%.
- It ranks 24th among all states, placing it in the average tier.
Radon:
- In Delaware, 15% of radon tests results were at or above the action level recommended by EPA.
- It ranks 17th among all states, placing it in the above average tier.
Racial & Ethnic Disparities
Black Americans:
- The rate of new lung cancer cases is 62 per 100,000 population among Black Americans in Delaware, not significantly different than the rate of 60 among Black Americans nationally, and significantly lower than the rate of 69 among whites in Delaware.
- The five-year survival rate is 24% among Black Americans in Delaware, not significantly different than the rate of 21% among Black Americans nationally, and not significantly different than the rate of 24% among whites in Delaware.
- 25% of lung cancer cases are diagnosed at an early stage among Black Americans in Delaware, not significantly different than the rate of 21% among Black Americans nationally, and not significantly different than the rate of 27% among whites in Delaware.
- 18% of Black Americans with lung cancer in Delaware underwent surgery, not significantly different than the rate of 17% among Black Americans nationally, and not significantly different than the rate of 19% among whites in Delaware.
- 21% of Black Americans with lung cancer in Delaware did not receive any treatment, not significantly different than the rate of 23% among Black Americans nationally, and not significantly different than the rate of 20% among whites in Delaware.
Latino Americans:
- The rate of new lung cancer cases is 29 per 100,000 population among Latinos in Delaware, not significantly different than the rate of 29 among Latinos nationally, and significantly lower than the rate of 69 among whites in Delaware.
- State-level survival rates are not available for Latino Americans at this time. Nationally, the five-year survival rate among Latino Americans is 19%, 13% lower than among white Americans.
- 38% of lung cancer cases are diagnosed at an early stage among Latinos in Delaware, significantly higher than the rate of 22% among Latinos nationally, and not significantly different than the rate of 27% among whites in Delaware.
- Other lung cancer rates are not available for Latino Americans in Delaware due to too few cases over the time period to allow for accurate analysis.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 24 per 100,000 population among Asian Americans or Pacific Islanders in Delaware, significantly lower than the rate of 34 among Asian Americans or Pacific Islanders nationally, and significantly lower than the rate of 69 among whites in Delaware.
- State-level survival rates are not available for Asian Americans or Pacific Islanders at this time. Nationally, the five-year survival rate among Asian Americans or Pacific Islanders is 23%, 8% higher than among white Americans.
- Other lung cancer rates are not available for Asian Americans or Pacific Islanders in Delaware due to too few cases over the time period to allow for accurate analysis.
Indigenous Peoples:
- Lung cancer rates are not available for Indigenous Peoples (American Indians/Alaska Natives) in Delaware due to too few cases over the time period to allow for accurate analysis.
Summary
Despite the early diagnosis rate in Delaware 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.
Delaware has improved access to screening by covering it through its fee-for-service Medicaid program. The Lung Association encourages all states to cover lung cancer screening based on recommended guidelines across all fee-for-service and managed care plans without any financial or administrative barriers in their Medicaid programs.
Delaware falls into the above average tier for percent of patients not receiving any 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.