South Dakota
Fee-For-Service Medicaid Coverage of Screening
Yes
Highlighted Disparity
Indigenous Peoples in South Dakota are most likely to be diagnosed with lung cancer.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 58 and not significantly different than the national rate of 58.
- South Dakota ranks 23rd among all states, placing it in the average tier.
- Over the last five years, the rate of new cases did not change significantly.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in South Dakota is 25%, which is not significantly different than the national rate of 24%.
- It ranks 15th among the 45 states with survival data, placing it in the average tier.
- The change in the survival rate over the last five years is not available for South Dakota.
Early Diagnosis:
- 26% of cases are caught at an early stage, which is not significantly than the national rate of 24%.
- It ranks 13th 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 South Dakota improved by 44%.
Lung Cancer Treatment
Surgical Treatment:
- South Dakota ranked 44th (out of the 49 states with available data) with 16% 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 South Dakota in the bottom tier.
- Over the last five years, the percent of cases undergoing surgery in South Dakota did not change significantly.
Lack of Treatment:
- South Dakota ranked 31st (out of the 49 states with available data) with 21% of cases not receiving any treatment.
- This is not significantly different than the national rate of 21% and puts South Dakota in the average tier.
- Over the last five years, the percent of cases receiving no treatment in South Dakota did not change significantly.
Screening
Screening for High Risk:
- In South Dakota, 10% of those at high risk were screened, which was significantly higher than the national rate of 6%.
- It ranks 9th among all states, placing it in the above average tier.
Medicaid Coverage:
- South Dakota was one of the 40 states whose Medicaid fee-for-service programs covered lung cancer screening as of September 2021.
- In addition, their program used recommended guidelines for determining eligibility and did not require prior authorization or cost sharing.
Prevention
Tobacco Use:
- The smoking rate in South Dakota is 18% and significantly higher than the national rate of 15%.
- It ranks 36th among all states, placing it in the below average tier.
Radon:
- In South Dakota, 60% of radon tests results were at or above the action level recommended by EPA.
- It ranks 51st among all states, placing it in the bottom tier.
Racial & Ethnic Disparities
Black Americans:
- Lung cancer rates are not available for Black Americans in South Dakota due to too few cases over the time period to allow for accurate analysis.
Latino Americans:
- Lung cancer rates are not available for Latino Americans in South Dakota due to too few cases over the time period to allow for accurate analysis.
Asian Americans or Pacific Islanders:
- Lung cancer rates are not available for Asian Americans or Pacific Islanders in South Dakota due to too few cases over the time period to allow for accurate analysis.
Indigenous Peoples:
- The rate of new lung cancer cases is 90 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in South Dakota, significantly higher than the rate of 41 among Indigenous Peoples nationally, and significantly higher than the rate of 57 among whites in South Dakota.
- 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.
- 22% of lung cancer cases are diagnosed at an early stage among Indigenous Peoples (American Indians/Alaska Natives) in South Dakota, not significantly different than the rate of 22% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and not significantly different than the rate of 26% among whites in South Dakota.
- 14% of Indigenous Peoples (American Indians/Alaska Natives) with lung cancer in South Dakota underwent surgery, not significantly different than the rate of 17% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and not significantly different than the rate of 16% among whites in South Dakota.
- 29% of Indigenous Peoples (American Indians/Alaska Natives) with lung cancer in South Dakota did not receive any treatment, not significantly different than the rate of 23% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and significantly higher than the rate of 21% among whites in South Dakota.
Summary
Despite the early diagnosis rate in South Dakota 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.
South Dakota 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.
South Dakota falls into the 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.