Alabama
Fee-For-Service Medicaid Coverage of Screening
Not Covered
Highlighted Disparity
Black individuals in Alabama are least likely to receive surgical treatment.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 60.5 and significantly higher than the national rate of 54.6.
- Alabama ranks 35th among all states, placing it in the average tier.
- Over the last five years, the rate of new cases improved by 19.1%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Alabama is 21.3%, which is significantly lower than the national rate of 26.6%.
- It ranks 41st among the 42 states with survival data, placing it in the bottom tier.
- Over the last five years, the survival rate in Alabama improved by 27%.
Early Diagnosis:
- 25.1% of cases are caught at an early stage, which is significantly lower than the national rate of 26.6%.
- It ranks 36th among the 47 states with data on diagnosis at an early stage, placing it in the below average tier.
- Over the last five years, the early diagnosis rate in Alabama did not change significantly.
Lung Cancer Treatment
Surgical Treatment:
- Alabama ranked 40th (out of the 47 states with available data) with 16.4% 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 Alabama in the bottom tier.
- Over the last five years, the percent of cases undergoing surgery in Alabama improved by -30%.
Lack of Treatment:
- Alabama ranked 37th (out of the 47 states with available data) with 22.2% of cases not receiving any treatment.
- This is significantly higher than the national rate of 20.6% and puts Alabama in the average tier.
- Over the last five years, the percent of cases receiving no treatment in Alabama increased by 29%.
Screening
Screening for High Risk:
- In Alabama, 4.4% of those at high risk were screened, which was not significantly different than the national rate of 4.5%.
- It ranks 29th among all states, placing it in the average tier.
- Actual screening rates may be higher in states with large, regional managed care providers that did not share screening data.
Medicaid Coverage:
- Alabama was the only state whose Medicaid fee-for-service programs did not cover lung cancer screening as of October 2023.
Prevention
Tobacco Use:
- The smoking rate in Alabama is 17.2% and significantly higher than the national rate of 13.5%.
- It ranks 42nd among all states, placing it in the below average tier.
Radon:
- In Alabama, 13.8% of radon tests results were at or above the action level recommended by EPA.
- It ranks 14th among all states, placing it in the above average tier.
Racial & Ethnic Disparities
Black individuals:
- The rate of new lung cancer cases is 53.4 per 100,000 population among Black individuals in Alabama, significantly lower than the rate of 56.3 among Black individuals nationally, and significantly lower than the rate of 63.8 among white individuals in Alabama.
- The five-year survival rate is 20.2% among Black individuals in Alabama, significantly lower than the rate of 23.8% among Black individuals nationally, and not significantly different than the rate of 21.4% among white individuals in Alabama.
- 20.7% of lung cancer cases are diagnosed at an early stage among Black individuals in Alabama, significantly lower than the rate of 23.2% among Black individuals nationally, and significantly lower than the rate of 26.1% among white individuals in Alabama.
- 13.1% of Black individuals with lung cancer in Alabama underwent surgery, significantly lower than the rate of 17.0% among Black individuals nationally, and significantly lower than the rate of 17.1% among white individuals in Alabama.
- 22.5% of Black individuals with lung cancer in Alabama 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 22.1% among white individuals in Alabama.
Latino individuals:
- The rate of new lung cancer cases is 18.8 per 100,000 population among Latino individuals in Alabama, significantly lower than the rate of 28.2 among Latino individuals nationally, and significantly lower than the rate of 63.8 among white individuals in Alabama.
- 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.
- 26.8% of lung cancer cases are diagnosed at an early stage among Latino individuals in Alabama, not significantly different than the rate of 23.1% among Latino individuals nationally, and not significantly different than the rate of 26.1% among white individuals in Alabama.
- 25.6% of Latino individuals with lung cancer in Alabama 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 22.1% among white individuals in Alabama.
- Other lung cancer rates are not available for Latino individuals in Alabama 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 35.6 per 100,000 population among Asian or Pacific Islanders individuals in Alabama, not significantly different than the rate of 32.9 among Asian or Pacific Islanders individuals nationally, and significantly lower than the rate of 63.8 among white individuals in Alabama.
- 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.
- 21.1% of lung cancer cases are diagnosed at an early stage among Asian or Pacific Islander individuals in Alabama, not significantly different than the rate of 22.8% among Asian or Pacific Islander individuals nationally, and not significantly different than the rate of 26.1% among white individuals in Alabama.
- 17.5% of Asian or Pacific Islander individuals with lung cancer in Alabama 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 17.1% among white individuals in Alabama.
- Other lung cancer rates are not available for Asian or Pacific Islander individuals in Alabama due to too few cases over the time period to allow for accurate analysis.
Indigenous Peoples:
- The rate of new lung cancer cases is 18.2 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Alabama, significantly lower than the rate of 39.4 among Indigenous Peoples nationally, and significantly lower than the rate of 63.8 among white individuals in Alabama.
- 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 Alabama due to too few cases over the time period to allow for accurate analysis.
Summary
The early diagnosis rate in Alabama falls into the below 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.
Alabama falls into the 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.