Alaska
Fee-For-Service Medicaid Coverage of Screening
Covered and Using Updated Guidelines
Highlighted Disparity
Indigenous Peoples in Alaska are most likely to be diagnosed with lung cancer.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 52.9 and not significantly different than the national rate of 54.6.
- Alaska ranks 18th 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 Alaska is 25.2%, which is not significantly different than the national rate of 26.6%.
- It ranks 24th among the 46 states with survival data, placing it in the below average tier.
- Over the last five years, the survival rate in Alaska improved by 43%.
Early Diagnosis:
- 24.2% of cases are caught at an early stage, which is significantly lower than the national rate of 26.6%.
- It ranks 42nd 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 Alaska did not change significantly.
Lung Cancer Treatment
Surgical Treatment:
- Alaska ranked 37th (out of the 47 states with available data) with 17.2% 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 Alaska in the below average tier.
- Over the last five years, the percent of cases undergoing surgery in Alaska did not change significantly.
Lack of Treatment:
- Alaska ranked 13th (out of the 49 states with available data) with 17.6% of cases not receiving any treatment.
- This is not significantly different than the national rate of 20.6% and puts Alaska in the above average tier.
- Over the last five years, the percent of cases receiving no treatment in Alaska did not change significantly.
Screening
Screening for High Risk:
- In Alaska, 3.6% of those at high risk were screened, which was not significantly different than the national rate of 4.5%.
- It ranks 35th among all states, placing it in the below average tier.
- Actual screening rates may be higher in states with large, regional managed care providers that did not share screening data.
Medicaid Coverage:
- Alaska was one of the 49 states whose Medicaid fee-for-service programs covered lung cancer screening as of October 2023.
- While their program did not require copays, they have not shown that it uses the latest recommended guidelines for determining eligibility and it did require prior authorization.
Prevention
Tobacco Use:
- The smoking rate in Alaska is 17.1% and not significantly different than the national rate of 13.5%.
- It ranks 41st among all states, placing it in the below average tier.
Radon:
- In Alaska, 16.9% of radon tests results were at or above the action level recommended by EPA.
- It ranks 18th among all states, placing it in the above average tier.
Racial & Ethnic Disparities
Black individuals:
- The rate of new lung cancer cases is 47.8 per 100,000 population among Black individuals in Alaska, not significantly different than the rate of 56.3 among Black individuals nationally, and not significantly different than the rate of 50.0 among white individuals in Alaska.
- The five-year survival rate is 33.6% among Black individuals in Alaska, not significantly different than the rate of 23.8% among Black individuals nationally, and not significantly different than the rate of 26.3% among white individuals in Alaska.
- Other lung cancer rates are not available for Black individuals in Alaska due to too few cases over the time period to allow for accurate analysis.
Latino individuals:
- The rate of new lung cancer cases is 34.0 per 100,000 population among Latino individuals in Alaska, not significantly different than the rate of 28.2 among Latino individuals nationally, and significantly lower than the rate of 50.0 among white individuals in Alaska.
- 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.
- Other lung cancer rates are not available for Latino individuals in Alaska 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 36.6 per 100,000 population among Asian or Pacific Islanders individuals in Alaska, not significantly different than the rate of 32.9 among Asian or Pacific Islanders individuals nationally, and significantly lower than the rate of 50.0 among white individuals in Alaska.
- 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.
- Other lung cancer rates are not available for Asian or Pacific Islander individuals in Alaska due to too few cases over the time period to allow for accurate analysis.
Indigenous Peoples:
- The rate of new lung cancer cases is 82.5 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Alaska, significantly higher than the rate of 39.4 among Indigenous Peoples nationally, and significantly higher than the rate of 50.0 among white individuals in Alaska.
- 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. 21.7% of lung cancer cases are diagnosed at an early stage among Indigenous Peoples (American Indians/Alaska Natives) in Alaska, not significantly different than the rate of 23.5% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and not significantly different than the rate of 25.6% among white individuals in Alaska.
- 11.2% of Indigenous Peoples (American Indians/Alaska Natives) with lung cancer in Alaska underwent surgery, significantly lower than the rate of 16.3% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and significantly lower than the rate of 19.1% among white individuals in Alaska.
- 17.5% of Indigenous Peoples (American Indians/Alaska Natives) with lung cancer in Alaska did not receive any treatment, significantly lower than the rate of 23.2% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and not significantly different than the rate of 17.8% among white individuals in Alaska.
Summary
The early diagnosis rate in Alaska 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.
Alaska has improved access to expanded screening by covering it through its fee-for-service Medicaid program. 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.
Alaska falls into the above 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.