Tennessee
Fee-For-Service Medicaid Coverage of Screening
No FFS Program
Highlighted Disparity
Black Americans in Tennessee are most likely to receive no treatment.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 74 and significantly higher than the national rate of 58.
- Tennessee ranks 48th among all states, placing it in the below average tier.
- Over the last five years, the rate of new cases improved by 7%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Tennessee is 21%, which is significantly lower than the national rate of 24%.
- It ranks 35th among the 45 states with survival data, placing it in the below average tier.
- The change in the survival rate over the last five years is not available for Tennessee.
Early Diagnosis:
- 23.9% of cases are caught at an early stage, which is significantly lower than the national rate of 24.5%.
- It ranks 33rd 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 Tennessee improved by 37%.
Lung Cancer Treatment
Surgical Treatment:
- Tennessee ranked 28th (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 Tennessee in the below average tier.
- Over the last five years, the percent of cases undergoing surgery in Tennessee improved by -11%.
Lack of Treatment:
- Tennessee ranked 14th (out of the 49 states with available data) with 18% of cases not receiving any treatment.
- This is significantly lower than the national rate of 21% and puts Tennessee in the above average tier.
- Over the last five years, the percent of cases receiving no treatment in Tennessee improved by 9%.
Screening
Screening for High Risk:
- In Tennessee, 6.3% of those at high risk were screened, which was significantly higher than the national rate of 6%.
- It ranks 26th among all states, placing it in the average tier.
Medicaid Coverage:
- Tennessee covers all Medicaid enrollees through managed care plans and therefore did not have a Medicaid fee-for-service program as of September 2021.
Prevention
Tobacco Use:
- The smoking rate in Tennessee is 20% and significantly higher than the national rate of 15%.
- It ranks 43rd among all states, placing it in the below average tier.
Radon:
- In Tennessee, 27% of radon tests results were at or above the action level recommended by EPA.
- It ranks 30th among all states, placing it in the average tier.
Racial & Ethnic Disparities
Black Americans:
- The rate of new lung cancer cases is 68 per 100,000 population among Black Americans in Tennessee, significantly higher than the rate of 60 among Black Americans nationally, and significantly lower than the rate of 77 among whites in Tennessee.
- The five-year survival rate is 19% among Black Americans in Tennessee, not significantly different than the rate of 21% among Black Americans nationally, and significantly lower than the rate of 22% among whites in Tennessee.
- 21% of lung cancer cases are diagnosed at an early stage among Black Americans in Tennessee, not significantly different than the rate of 21% among Black Americans nationally, and significantly lower than the rate of 24% among whites in Tennessee.
- 17% of Black Americans with lung cancer in Tennessee underwent surgery, not significantly different than the rate of 17% among Black Americans nationally, and significantly lower than the rate of 19% among whites in Tennessee.
- 22% of Black Americans with lung cancer in Tennessee did not receive any treatment, not significantly different than the rate of 23% among Black Americans nationally, and significantly higher than the rate of 18% among whites in Tennessee.
Latino Americans:
- The rate of new lung cancer cases is 37 per 100,000 population among Latinos in Tennessee, significantly higher than the rate of 29 among Latinos nationally, and significantly lower than the rate of 77 among whites in Tennessee.
- 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.
- 22% of lung cancer cases are diagnosed at an early stage among Latinos in Tennessee, not significantly different than the rate of 22% among Latinos nationally, and not significantly different than the rate of 24% among whites in Tennessee.
- 18% of Latinos with lung cancer in Tennessee underwent surgery, not significantly different than the rate of 21% among Latinos nationally, and not significantly different than the rate of 19% among whites in Tennessee.
- 15% of Latinos with lung cancer in Tennessee did not receive any treatment, significantly lower than the rate of 26% among Latinos nationally, and not significantly different than the rate of 18% among whites in Tennessee.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 35 per 100,000 population among Asian Americans or Pacific Islanders in Tennessee, not significantly different than the rate of 34 among Asian Americans or Pacific Islanders nationally, and significantly lower than the rate of 77 among whites in Tennessee.
- 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.
- 23% of lung cancer cases are diagnosed at an early stage among Asian Americans or Pacific Islanders in Tennessee, not significantly different than the rate of 21% among Asian Americans or Pacific Islanders nationally, and not significantly different than the rate of 24% among whites in Tennessee.
- 29% of Asian Americans or Pacific Islanders with lung cancer in Tennessee underwent surgery, not significantly different than the rate of 24% among Asian Americans or Pacific Islanders nationally, and significantly higher than the rate of 19% among whites in Tennessee.
- Other lung cancer rates are not available for Asian Americans or Pacific Islanders in Tennessee due to too few cases over the time period to allow for accurate analysis.
Indigenous Peoples:
- The rate of new lung cancer cases is 16 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Tennessee, significantly lower than the rate of 41 among Indigenous Peoples nationally, and significantly lower than the rate of 77 among whites in Tennessee.
- 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 Tennessee due to too few cases over the time period to allow for accurate analysis.
Summary
Despite the early diagnosis rate in Tennessee 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.
Tennessee falls into the above 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.