Florida
Fee-For-Service Medicaid Coverage of Screening
Covered and Using Updated Guidelines
Highlighted Disparity
Black individuals in Florida are least likely to receive surgical treatment.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 54.7 and not significantly different than the national rate of 54.6.
- Florida ranks 20th among all states, placing it in the average tier.
- Over the last five years, the rate of new cases improved by 16%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Florida is 27.6%, which is significantly higher than the national rate of 26.6%.
- It ranks 14th among the 42 states with survival data, placing it in the average tier.
- Over the last five years, the survival rate in Florida improved by 20%.
Early Diagnosis:
- 24.9% of cases are caught at an early stage, which is significantly lower than the national rate of 26.6%.
- It ranks 37th 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 Florida did not change significantly.
Lung Cancer Treatment
Surgical Treatment:
- Florida ranked 20th (out of the 47 states with available data) with 20.6% of cases undergoing surgery as part of the first course of treatment.
- This is not significantly different than the national rate of 20.8% and puts Florida in the average tier.
- Over the last five years, the percent of cases undergoing surgery in Florida did not change significantly.
Lack of Treatment:
- Florida ranked 43rd (out of the 47 states with available data) with 25.6% of cases not receiving any treatment.
- This is significantly higher than the national rate of 20.6% and puts Florida in the below average tier.
- Over the last five years, the percent of cases receiving no treatment in Florida increased by 10%.
Screening
Screening for High Risk:
- In Florida, 2.4% of those at high risk were screened, which was significantly lower than the national rate of 4.5%.
- It ranks 42nd 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:
- Florida 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 prior authorization, it did not use recommended guidelines for determining eligibility and required copays.
Prevention
Tobacco Use:
- The smoking rate in Florida is 14.7% and not significantly different than the national rate of 13.5%.
- It ranks 29th among all states, placing it in the average tier.
Radon:
- In Florida, 12.1% of radon tests results were at or above the action level recommended by EPA.
- It ranks 11th among all states, placing it in the above average tier.
Racial & Ethnic Disparities
Black individuals:
- The rate of new lung cancer cases is 42.5 per 100,000 population among Black individuals in Florida, significantly lower than the rate of 56.3 among Black individuals nationally, and significantly lower than the rate of 62.0 among white individuals in Florida.
- The five-year survival rate is 23.9% among Black individuals in Florida, not significantly different than the rate of 23.8% among Black individuals nationally, and significantly lower than the rate of 27.6% among white individuals in Florida.
- 20.9% of lung cancer cases are diagnosed at an early stage among Black individuals in Florida, significantly lower than the rate of 23.2% among Black individuals nationally, and significantly lower than the rate of 25.6% among white individuals in Florida.
- 15.1% of Black individuals with lung cancer in Florida underwent surgery, significantly lower than the rate of 17.0% among Black individuals nationally, and significantly lower than the rate of 20.2% among white individuals in Florida.
- 30.8% of Black individuals with lung cancer in Florida did not receive any treatment, significantly higher than the rate of 22.4% among Black individuals nationally, and significantly higher than the rate of 25.0% among white individuals in Florida.
Latino individuals:
- The rate of new lung cancer cases is 36.2 per 100,000 population among Latino individuals in Florida, significantly higher than the rate of 28.2 among Latino individuals nationally, and significantly lower than the rate of 62.0 among white individuals in Florida.
- 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.
- 24.0% of lung cancer cases are diagnosed at an early stage among Latino individuals in Florida, not significantly different than the rate of 23.1% among Latino individuals nationally, and significantly lower than the rate of 25.6% among white individuals in Florida.
- 27.2% of Latino individuals with lung cancer in Florida underwent surgery, significantly higher than the rate of 21.6% among Latino individuals nationally, and significantly higher than the rate of 20.2% among white individuals in Florida.
- 26.4% of Latino individuals with lung cancer in Florida did not receive any treatment, not significantly different than the rate of 26.1% among Latino individuals nationally, and significantly higher than the rate of 25.0% among white individuals in Florida.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 26.0 per 100,000 population among Asian or Pacific Islanders individuals in Florida, significantly lower than the rate of 32.9 among Asian or Pacific Islanders individuals nationally, and significantly lower than the rate of 62.0 among white individuals in Florida.
- 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.
- 21.9% of lung cancer cases are diagnosed at an early stage among Asian or Pacific Islander individuals in Florida, not significantly different than the rate of 22.8% among Asian or Pacific Islander individuals nationally, and significantly lower than the rate of 25.6% among white individuals in Florida.
- 23.4% of Asian or Pacific Islander individuals with lung cancer in Florida underwent surgery, not significantly different than the rate of 24.7% among Asian or Pacific Islander individuals nationally, and significantly higher than the rate of 20.2% among white individuals in Florida.
- 21.4% of Asian or Pacific Islander individuals with lung cancer in Florida did not receive any treatment, not significantly different than the rate of 20.2% among Asian or Pacific Islander individuals nationally, and significantly lower than the rate of 25.0% among white individuals in Florida.
Indigenous Peoples:
- The rate of new lung cancer cases is 26.2 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Florida, significantly lower than the rate of 39.4 among Indigenous Peoples nationally, and significantly lower than the rate of 62.0 among white individuals in Florida.
- 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.
- 24.8% of lung cancer cases are diagnosed at an early stage among Indigenous Peoples (American Indians/Alaska Natives) in Florida, 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 Florida.
- 23.0% of Indigenous Peoples (American Indians/Alaska Natives) with lung cancer in Florida underwent surgery, significantly higher than the rate of 16.3% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and not significantly different than the rate of 20.2% among white individuals in Florida.
- 20.6% of Indigenous Peoples (American Indians/Alaska Natives) with lung cancer in Florida did not receive any treatment, not significantly different than the rate of 23.2% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and not significantly different than the rate of 25.0% among white individuals in Florida.
Summary
The early diagnosis rate in Florida 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.
Florida 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.
It is alarming that Florida falls into the below 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.