Maryland
Fee-For-Service Medicaid Coverage of Screening
Covered
Highlighted Disparity
Asian or Pacific Islander individuals in Maryland are least likely to be diagnosed early.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 52.1 and significantly lower than the national rate of 54.6.
- Maryland ranks 15th among all states, placing it in the average tier.
- Over the last five years, the rate of new cases improved by 22%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Maryland is 28.4%, which is significantly higher than the national rate of 26.6%.
- It ranks 11th among the 42 states with survival data, placing it in the above average tier.
- Over the last five years, the survival rate in Maryland improved by 11%.
Early Diagnosis:
- 26.8% of cases are caught at an early stage, which is not significantly different than the national rate of 26.6%.
- It ranks 24th among the 47 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 Maryland did not change significantly.
Lung Cancer Treatment
Surgical Treatment:
- Maryland ranked 7th (out of the 47 states with available data) with 24.2% of cases undergoing surgery as part of the first course of treatment.
- This is significantly higher than the national rate of 20.8% and puts Maryland in the above average tier.
- Over the last five years, the percent of cases undergoing surgery in Maryland did not change significantly.
Lack of Treatment:
- Maryland ranked 14th (out of the 47 states with available data) with 17.8% of cases not receiving any treatment.
- This is significantly lower than the national rate of 20.6% and puts Maryland in the above average tier.
- Over the last five years, the percent of cases receiving no treatment in Maryland did not change significantly.
Screening
Screening for High Risk:
- In Maryland, 2.9% of those at high risk were screened, which was significantly lower than the national rate of 4.5%.
- It ranks 36th 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:
- Maryland 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 or copays, it did not use recommended guidelines for determining eligibility.
Prevention
Tobacco Use:
- The smoking rate in Maryland is 10.1% and significantly lower than the national rate of 13.5%.
- It ranks 5th among all states, placing it in the above average tier.
Radon:
- In Maryland, 20.8% of radon tests results were at or above the action level recommended by EPA.
- It ranks 21st among all states, placing it in the average tier.
Racial & Ethnic Disparities
Black individuals:
- The rate of new lung cancer cases is 51.1 per 100,000 population among Black individuals in Maryland, significantly lower than the rate of 56.3 among Black individuals nationally, and significantly lower than the rate of 56.9 among white individuals in Maryland.
- The five-year survival rate is 28.3% among Black individuals in Maryland, significantly higher than the rate of 23.8% among Black individuals nationally, and not significantly different than the rate of 28.1% among white individuals in Maryland.
- 24.6% of lung cancer cases are diagnosed at an early stage among Black individuals in Maryland, not significantly different than the rate of 23.2% among Black individuals nationally, and significantly lower than the rate of 27.9% among white individuals in Maryland.
- 21.4% of Black individuals with lung cancer in Maryland underwent surgery, significantly higher than the rate of 17.0% among Black individuals nationally, and significantly lower than the rate of 25.1% among white individuals in Maryland.
- 19.3% of Black individuals with lung cancer in Maryland did not receive any treatment, significantly lower than the rate of 22.4% among Black individuals nationally, and significantly higher than the rate of 17.4% among white individuals in Maryland.
Latino individuals:
- The rate of new lung cancer cases is 17.4 per 100,000 population among Latino individuals in Maryland, significantly lower than the rate of 28.2 among Latino individuals nationally, and significantly lower than the rate of 56.9 among white individuals in Maryland.
- 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.
- 22.3% of lung cancer cases are diagnosed at an early stage among Latino individuals in Maryland, not significantly different than the rate of 23.1% among Latino individuals nationally, and not significantly different than the rate of 27.9% among white individuals in Maryland.
- 26.4% of Latino individuals with lung cancer in Maryland underwent surgery, not significantly different than the rate of 21.6% among Latino individuals nationally, and not significantly different than the rate of 25.1% among white individuals in Maryland.
- 16.0% of Latino individuals with lung cancer in Maryland did not receive any treatment, significantly lower than the rate of 26.1% among Latino individuals nationally, and not significantly different than the rate of 17.4% among white individuals in Maryland.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 27.9 per 100,000 population among Asian or Pacific Islanders individuals in Maryland, significantly lower than the rate of 32.9 among Asian or Pacific Islanders individuals nationally, and significantly lower than the rate of 56.9 among white individuals in Maryland.
- 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.
- 21.7% of lung cancer cases are diagnosed at an early stage among Asian or Pacific Islander individuals in Maryland, not significantly different than the rate of 22.8% among Asian or Pacific Islander individuals nationally, and significantly lower than the rate of 27.9% among white individuals in Maryland.
- 25.0% of Asian or Pacific Islander individuals with lung cancer in Maryland 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 25.1% among white individuals in Maryland.
- 14.7% of Asian or Pacific Islander individuals with lung cancer in Maryland did not receive any treatment, significantly lower than the rate of 20.2% among Asian or Pacific Islander individuals nationally, and not significantly different than the rate of 17.4% among white individuals in Maryland.
Indigenous Peoples:
- The rate of new lung cancer cases is 19.9 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Maryland, significantly lower than the rate of 39.4 among Indigenous Peoples nationally, and significantly lower than the rate of 56.9 among white individuals in Maryland.
- 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 Maryland due to too few cases over the time period to allow for accurate analysis.
Summary
Despite the early diagnosis rate in Maryland 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 the latest guidelines across all fee-for-service and managed care plans without any financial or administrative barriers in their Medicaid programs.
Maryland 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.