Massachusetts
Fee-For-Service Medicaid Coverage of Screening
Yes
Highlighted Disparity
Asian Americans or Pacific Islanders in Massachusetts are least likely to be diagnosed early.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 61 and significantly higher than the national rate of 58.
- Massachusetts ranks 29th among all states, placing it in the average tier.
- Over the last five years, the rate of new cases improved by 14%.
5-Year Survival Rate:
- The percent of people still alive five years after being diagnosed with lung cancer (the survival rate) is 24% nationally.
- Massachusetts is one of the 6 states for which survival data is not available as they do not track cases after diagnosis.
Early Diagnosis:
- 30% of cases are caught at an early stage, which is significantly higher than the national rate of 24%.
- It ranks 1st among the 49 states with data on diagnosis at an early stage, placing it in the top tier.
- Over the last five years, the early diagnosis rate in Massachusetts improved by 27%.
Lung Cancer Treatment
Surgical Treatment:
- Massachusetts ranked 1st (out of the 49 states with available data) with 31% of cases undergoing surgery as part of the first course of treatment.
- This is significantly higher than the national rate of 20.7% and puts Massachusetts in the top tier.
- Over the last five years, the percent of cases undergoing surgery in Massachusetts improved by 7%.
Lack of Treatment:
- Massachusetts ranked 3rd (out of the 49 states with available data) with 15% of cases not receiving any treatment.
- This is significantly lower than the national rate of 21% and puts Massachusetts in the top tier.
- Over the last five years, the percent of cases receiving no treatment in Massachusetts improved by 22%.
Screening
Screening for High Risk:
- In Massachusetts, 18% of those at high risk were screened, which was significantly higher than the national rate of 6%.
- It ranks 1st among all states, placing it in the top tier.
Medicaid Coverage:
- Massachusetts was one of the 40 states whose Medicaid fee-for-service programs covered lung cancer screening as of September 2021.
- While their program did not require prior authorization or cost sharing, it did not use recommended guidelines for determining eligibility.
Prevention
Tobacco Use:
- The smoking rate in Massachusetts is 12% and significantly lower than the national rate of 15%.
- It ranks 3rd among all states, placing it in the above average tier.
Radon:
- In Massachusetts, 22% of radon tests results were at or above the action level recommended by EPA.
- It ranks 25th among all states, placing it in the average tier.
Racial & Ethnic Disparities
Black Americans:
- The rate of new lung cancer cases is 45 per 100,000 population among Black Americans in Massachusetts, significantly lower than the rate of 60 among Black Americans nationally, and significantly lower than the rate of 63 among whites in Massachusetts.
- Survival rates by race and ethnicity are not available for Massachusetts at this time.
- 28% of lung cancer cases are diagnosed at an early stage among Black Americans in Massachusetts, significantly higher than the rate of 21% among Black Americans nationally, and not significantly different than the rate of 31% among whites in Massachusetts.
- 30% of Black Americans with lung cancer in Massachusetts underwent surgery, significantly higher than the rate of 17% among Black Americans nationally, and not significantly different than the rate of 31% among whites in Massachusetts.
- 16% of Black Americans with lung cancer in Massachusetts did not receive any treatment, significantly lower than the rate of 23% among Black Americans nationally, and not significantly different than the rate of 15% among whites in Massachusetts.
Latino Americans:
- The rate of new lung cancer cases is 30 per 100,000 population among Latinos in Massachusetts, not significantly different than the rate of 29 among Latinos nationally, and significantly lower than the rate of 63 among whites in Massachusetts.
- Survival rates by race and ethnicity are not available for Massachusetts at this time.
- 28% of lung cancer cases are diagnosed at an early stage among Latinos in Massachusetts, significantly higher than the rate of 22% among Latinos nationally, and not significantly different than the rate of 31% among whites in Massachusetts.
- 32% of Latinos with lung cancer in Massachusetts underwent surgery, significantly higher than the rate of 21% among Latinos nationally, and not significantly different than the rate of 31% among whites in Massachusetts.
- 15% of Latinos with lung cancer in Massachusetts did not receive any treatment, significantly lower than the rate of 26% among Latinos nationally, and not significantly different than the rate of 15% among whites in Massachusetts.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 40 per 100,000 population among Asian Americans or Pacific Islanders in Massachusetts, significantly higher than the rate of 34 among Asian Americans or Pacific Islanders nationally, and significantly lower than the rate of 63 among whites in Massachusetts.
- Survival rates by race and ethnicity are not available for Massachusetts at this time.
- 21% of lung cancer cases are diagnosed at an early stage among Asian Americans or Pacific Islanders in Massachusetts, not significantly different than the rate of 21% among Asian Americans or Pacific Islanders nationally, and significantly lower than the rate of 31% among whites in Massachusetts.
- 29% of Asian Americans or Pacific Islanders with lung cancer in Massachusetts underwent surgery, significantly higher than the rate of 24% among Asian Americans or Pacific Islanders nationally, and not significantly different than the rate of 31% among whites in Massachusetts.
- 15% of Asian Americans or Pacific Islanders with lung cancer in Massachusetts did not receive any treatment, significantly lower than the rate of 22% among Asian Americans or Pacific Islanders nationally, and not significantly different than the rate of 15% among whites in Massachusetts.
Indigenous Peoples:
- The rate of new lung cancer cases is 21 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Massachusetts, significantly lower than the rate of 41 among Indigenous Peoples nationally, and significantly lower than the rate of 63 among whites in Massachusetts.
- State-level survival rates are not available for Indigenous Peoples at this time. Nationally, the five-year survival rate among Indigenous Peoples is 19%, 11% lower than among white Americans.
- Other lung cancer rates are not available for Indigenous Peoples (American Indians/Alaska Natives) in Massachusetts due to too few cases over the time period to allow for accurate analysis.
Summary
Despite the early diagnosis rate in Massachusetts falling into the top 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.
Massachusetts 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.
Massachusetts falls into the top 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.