South Carolina
Fee-For-Service Medicaid Coverage of Screening
Yes
Highlighted Disparity
Black Americans in South Carolina are least likely to receive surgical treatment.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 63 and significantly higher than the national rate of 58.
- South Carolina ranks 34th among all states, placing it in the average tier.
- Over the last five years, the rate of new cases improved by 13%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in South Carolina is 21%, which is significantly lower than the national rate of 24%.
- It ranks 34th among the 45 states with survival data, placing it in the below average tier.
- Over the last five years, the survival rate in South Carolina improved by 15%.
Early Diagnosis:
- 24% of cases are caught at an early stage, which is not significantly different than the national rate of 24%.
- It ranks 28th 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 South Carolina improved by 33%.
Lung Cancer Treatment
Surgical Treatment:
- South Carolina ranked 32nd (out of the 49 states with available data) with 19% 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 South Carolina in the below average tier.
- Over the last five years, the percent of cases undergoing surgery in South Carolina did not change significantly.
Lack of Treatment:
- South Carolina ranked 26th (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 South Carolina in the average tier.
- Over the last five years, the percent of cases receiving no treatment in South Carolina did not change significantly.
Screening
Screening for High Risk:
- In South Carolina 6% of those at high risk were screened, which was not significantly different than the national rate of 6%.
- It ranks 29th among all states, placing it in the average tier.
Medicaid Coverage:
- South Carolina was one of the 40 states whose Medicaid fee-for-service programs covered lung cancer screening as of September 2021.
- In addition, their program used recommended guidelines for determining eligibility and did not require prior authorization or cost sharing.
Prevention
Tobacco Use:
- The smoking rate in South Carolina is 18% and significantly higher than the national rate of 15%.
- It ranks 34th among all states, placing it in the below average tier.
Radon:
- In South Carolina, 10% of radon tests results were at or above the action level recommended by EPA.
- It ranks 9th among all states, placing it in the above average tier.
Racial & Ethnic Disparities
Black Americans:
- The rate of new lung cancer cases is 58 per 100,000 population among Black Americans in South Carolina, not significantly different than the rate of 60 among Black Americans nationally, and significantly lower than the rate of 66 among whites in South Carolina.
- The five-year survival rate is 19% among Black Americans in South Carolina, not significantly different than the rate of 21% among Black Americans nationally, and significantly lower than the rate of 22% among whites in South Carolina.
- 20% of lung cancer cases are diagnosed at an early stage among Black Americans in South Carolina, not significantly different than the rate of 21% among Black Americans nationally, and significantly lower than the rate of 25% among whites in South Carolina.
- 15% of Black Americans with lung cancer in South Carolina underwent surgery, significantly lower than the rate of 17% among Black Americans nationally, and significantly lower than the rate of 20% among whites in South Carolina.
- 23% of Black Americans with lung cancer in South Carolina did not receive any treatment, not significantly different than the rate of 23% among Black Americans nationally, and significantly higher than the rate of 20% among whites in South Carolina.
Latino Americans:
- The rate of new lung cancer cases is 24 per 100,000 population among Latinos in South Carolina, significantly lower than the rate of 29 among Latinos nationally, and significantly lower than the rate of 66 among whites in South Carolina.
- 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.
- 25% of lung cancer cases are diagnosed at an early stage among Latinos in South Carolina, not significantly different than the rate of 22% among Latinos nationally, and not significantly different than the rate of 25% among whites in South Carolina.
- 23% of Latinos with lung cancer in South Carolina underwent surgery, not significantly different than the rate of 21% among Latinos nationally, and not significantly different than the rate of 20% among whites in South Carolina.
- 15% of Latinos with lung cancer in South Carolina did not receive any treatment, significantly lower than the rate of 26% among Latinos nationally, and not significantly different than the rate of 20% among whites in South Carolina.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 30 per 100,000 population among Asian Americans or Pacific Islanders in South Carolina, not significantly different than the rate of 34 among Asian Americans or Pacific Islanders nationally, and significantly lower than the rate of 66 among whites in South Carolina.
- 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.
- 20% of lung cancer cases are diagnosed at an early stage among Asian Americans or Pacific Islanders in South Carolina, 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 South Carolina.
- Other lung cancer rates are not available for Asian Americans or Pacific Islanders in South Carolina due to too few cases over the time period to allow for accurate analysis.
Indigenous Peoples:
- The rate of new lung cancer cases is 22 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in South Carolina, significantly lower than the rate of 41 among Indigenous Peoples nationally, and significantly lower than the rate of 66 among whites in South Carolina.
- 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 South Carolina due to too few cases over the time period to allow for accurate analysis.
Summary
Despite the early diagnosis rate in South Carolina 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.
South Carolina has improved access to screening by covering it through its fee-for-service Medicaid program. 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.
South Carolina 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.