Tennessee
Fee-For-Service Medicaid Coverage of Screening
No Fee-for-Service Program
Highlighted Disparity
Black individuals in Tennessee are most likely to receive no treatment.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 70.0 and significantly higher than the national rate of 54.6.
- Tennessee ranks 45th among all states, placing it in the below average tier.
- Over the last five years, the rate of new cases improved by 20%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Tennessee is 23.6%, which is significantly lower than the national rate of 26.6%.
- It ranks 33rd among the 42 states with survival data, placing it in the below average tier.
- Over the last five years, the survival rate in Tennessee improved by 26%.
Early Diagnosis:
- 25.9% of cases are caught at an early stage, which is significantly lower than the national rate of 26.6%.
- It ranks 31st 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 Tennessee did not change significantly.
Lung Cancer Treatment
Surgical Treatment:
- Tennessee ranked 33rd (out of the 47 states with available data) with 18.0% 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 Tennessee in the below average tier.
- Over the last five years, the percent of cases undergoing surgery in Tennessee improved by -20%.
Lack of Treatment:
- Tennessee ranked 10th (out of the 47 states with available data) with 17.4% of cases not receiving any treatment.
- This is significantly lower than the national rate of 20.6% and puts Tennessee in the above average tier.
- Over the last five years, the percent of cases receiving no treatment in Tennessee did not change significantly.
Screening
Screening for High Risk:
- In Tennessee, 4.2% of those at high risk were screened, which was not significantly different than the national rate of 4.5%.
- It ranks 30th among all states, placing it in the average tier.
- Actual screening rates may be higher in states with large, regional managed care providers that did not share screening data.
Medicaid Coverage:
- Actual screening rates may be higher in states with large, regional managed care providers that did not share screening data.
Prevention
Tobacco Use:
- The smoking rate in Tennessee is 19.7% and significantly higher than the national rate of 13.5%.
- It ranks 49th among all states, placing it in the bottom tier.
Radon:
- In Tennessee, 26.8% 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 individuals:
- The rate of new lung cancer cases is 62.1 per 100,000 population among Black individuals in Tennessee, significantly higher than the rate of 56.3 among Black individuals nationally, and significantly lower than the rate of 72.5 among white individuals in Tennessee.
- The five-year survival rate is 22.1% among Black individuals in Tennessee, not significantly different than the rate of 23.8% among Black individuals nationally, and not significantly different than the rate of 23.7% among white individuals in Tennessee.
- 23.5% of lung cancer cases are diagnosed at an early stage among Black individuals in Tennessee, not significantly different than the rate of 23.2% among Black individuals nationally, and significantly lower than the rate of 26.2% among white individuals in Tennessee.
- 16.2% of Black individuals with lung cancer in Tennessee underwent surgery, not significantly different than the rate of 17.0% among Black individuals nationally, and significantly lower than the rate of 18.2% among white individuals in Tennessee.
- 20.3% of Black individuals with lung cancer in Tennessee did not receive any treatment, significantly lower than the rate of 22.4% among Black individuals nationally, and significantly higher than the rate of 17.2% among white individuals in Tennessee.
Latino individuals:
- The rate of new lung cancer cases is 33.8 per 100,000 population among Latino individuals in Tennessee, not significantly different than the rate of 28.2 among Latino individuals nationally, and significantly lower than the rate of 72.5 among white individuals in Tennessee.
- 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.
- 24.9% of lung cancer cases are diagnosed at an early stage among Latino individuals in Tennessee, not significantly different than the rate of 23.1% among Latino individuals nationally, and not significantly different than the rate of 26.2% among white individuals in Tennessee.
- 21.2% of Latino individuals with lung cancer in Tennessee underwent surgery, not significantly different than the rate of 21.6% among Latino individuals nationally, and not significantly different than the rate of 18.2% among white individuals in Tennessee.
- 12.4% of Latino individuals with lung cancer in Tennessee did not receive any treatment, significantly lower than the rate of 26.1% among Latino individuals nationally, and significantly lower than the rate of 17.2% among white individuals in Tennessee.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 29.0 per 100,000 population among Asian or Pacific Islanders individuals in Tennessee, not significantly different than the rate of 32.9 among Asian or Pacific Islanders individuals nationally, and significantly lower than the rate of 72.5 among white individuals in Tennessee.
- 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.
- 19.5% of lung cancer cases are diagnosed at an early stage among Asian or Pacific Islander individuals in Tennessee, not significantly different than the rate of 22.8% among Asian or Pacific Islander individuals nationally, and not significantly different than the rate of 26.2% among white individuals in Tennessee.
- 26.2% of Asian or Pacific Islander individuals with lung cancer in Tennessee 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 18.2% among white individuals in Tennessee.
- 14.1% of Asian or Pacific Islander individuals with lung cancer in Tennessee 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 17.2% among white individuals in Tennessee.
Indigenous Peoples:
- The rate of new lung cancer cases is 16.7 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Tennessee, significantly lower than the rate of 39.4 among Indigenous Peoples nationally, and significantly lower than the rate of 72.5 among white individuals 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 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 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 the latest 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 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.