Alabama
Fee-For-Service Medicaid Coverage of Screening
No
Highlighted Disparity
Black Americans in Alabama are least likely to receive surgical treatment.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 64 and significantly higher than the national rate of 58.
- Alabama ranks 37th among all states, placing it in the below average tier.
- Over the last five years, the rate of new cases improved by 7.5%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Alabama is 18%, which is significantly lower than the national rate of 24%.
- It ranks 45th among the 45 states with survival data, placing it in the bottom tier.
- Over the last five years, the survival rate in Alabama improved by 10%.
Early Diagnosis:
- 23.7% of cases are caught at an early stage, which is significantly lower than the national rate of 24.5%.
- It ranks 35th among the 49 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 Alabama improved by 58%.
Lung Cancer Treatment
Surgical Treatment:
- Alabama ranked 38th (out of the 49 states with available data) with 18% 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 Alabama in the below average tier.
- Over the last five years, the percent of cases undergoing surgery in Alabama did not change significantly.
Lack of Treatment:
- Alabama ranked 27th (out of the 49 states with available data) with 20% of cases not receiving any treatment.
- This is significantly lower than the national rate of 21% and puts Alabama in the average tier.
- Over the last five years, the percent of cases receiving no treatment in Alabama did not change significantly.
Screening
Screening for High Risk:
- In Alabama, 5% of those at high risk were screened, which was not significantly different than the national rate of 6%.
- It ranks 34th among all states, placing it in the average tier.
Medicaid Coverage:
- Alabama was one of the 7 states whose Medicaid fee-for-service programs did not cover lung cancer screening as of September 2021.
Prevention
Tobacco Use:
- The smoking rate in Alabama is 20% and significantly higher than the national rate of 15%.
- It ranks 44th among all states, placing it in the below average tier.
Radon:
- In Alabama, 14% 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 Americans:
- The rate of new lung cancer cases is 56 per 100,000 population among Black Americans in Alabama, significantly lower than the rate of 60 among Black Americans nationally, and significantly lower than the rate of 67 among whites in Alabama.
- The five-year survival rate is 16% among Black Americans in Alabama, significantly lower than the rate of 21% among Black Americans nationally, and significantly lower than the rate of 19% among whites in Alabama.
- 20% of lung cancer cases are diagnosed at an early stage among Black Americans in Alabama, significantly lower than the rate of 21% among Black Americans nationally, and significantly lower than the rate of 25% among whites in Alabama.
- 14% of Black Americans with lung cancer in Alabama underwent surgery, significantly lower than the rate of 17% among Black Americans nationally, and significantly lower than the rate of 18% among whites in Alabama.
- 21% of Black Americans with lung cancer in Alabama 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 Alabama.
Latino Americans:
- The rate of new lung cancer cases is 19 per 100,000 population among Latinos in Alabama, significantly lower than the rate of 29 among Latinos nationally, and significantly lower than the rate of 67 among whites in Alabama.
- 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.
- 34% of lung cancer cases are diagnosed at an early stage among Latinos in Alabama, not significantly different than the rate of 22% among Latinos nationally, and not significantly different than the rate of 25% among whites in Alabama.
- 30% of Latinos with lung cancer in Alabama underwent surgery, not significantly different than the rate of 21% among Latinos nationally, and significantly higher than the rate of 18% among whites in Alabama.
- Other lung cancer rates are not available for Latino Americans 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 36 per 100,000 population among Asian Americans or Pacific Islanders in Alabama, not significantly different than the rate of 34 among Asian Americans or Pacific Islanders nationally, and significantly lower than the rate of 67 among whites in Alabama.
- 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.
- 25% of lung cancer cases are diagnosed at an early stage among Asian Americans or Pacific Islanders in Alabama, not significantly different than the rate of 21% among Asian Americans or Pacific Islanders nationally, and not significantly different than the rate of 25% among whites in Alabama.
- 21% of Asian Americans or Pacific Islanders with lung cancer in Alabama did not receive any treatment, not significantly different than the rate of 22% among Asian Americans or Pacific Islanders nationally, and not significantly different than the rate of 20% among whites in Alabama.
- Other lung cancer rates are not available for Asian Americans or Pacific Islanders 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 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Alabama, significantly lower than the rate of 41 among Indigenous Peoples nationally, and significantly lower than the rate of 67 among whites 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 19%, 11% lower than among white Americans.
- 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
Despite the early diagnosis rate in Alabama 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 recommended 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 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.