West Virginia
Fee-For-Service Medicaid Coverage of Screening
Covered and Using Updated Guidelines
Highlighted Disparity
No racial disparities were found in West Virginia for these lung cancer metrics.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 76.1 and significantly higher than the national rate of 54.6.
- West Virginia ranks 47th among all states, placing it in the bottom tier.
- Over the last five years, the rate of new cases in West Virginia improved by 13%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in West Virginia is 22.4%, which is significantly lower than the national rate of 26.6%.
- It ranks 37th among the 42 states with survival data, placing it in the bottom tier.
- Over the last five years, the survival rate in West Virginia improved by 23%.
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 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 West Virginia improved by 24%.
Lung Cancer Treatment
Surgical Treatment:
- West Virginia ranked 21st (out of the 47 states with available data) with 20.4% 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 West Virginia in the average tier.
- Over the last five years, the percent of cases undergoing surgery in West Virginia did not change signficantly.
Lack of Treatment:
- West Virginia ranked 34th (out of the 47 states with available data) with 21.6% of cases not receiving any treatment.
- This is significantly higher than the national rate of 20.6% and puts West Virginia in the average tier.
- Over the last five years, the percent of cases receiving no treatment in West Virginia did not change significantly.
Screening
Screening for High Risk:
- In West Virginia, 5.0% of those at high risk were screened, which was not significantly different than the national rate of 4.5%.
- It ranks 25th 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:
- West Virginia was one of the 49 states whose Medicaid fee-for-service programs covered lung cancer screening as of October 2023.
- While their program used recommended guidelines for determining eligibility and did not require copays, it did require prior authorization.
Prevention
Tobacco Use:
- The smoking rate in West Virginia is 22.0% and significantly higher than the national rate of 13.5%.
- It ranks 51st among all states, placing it in the bottom tier.
Radon:
- In West Virginia, 28.5% of radon tests results were at or above the action level recommended by EPA.
- It ranks 31st among all states, placing it in the average tier.
Racial & Ethnic Disparities
Black individuals:
- The rate of new lung cancer cases is 68.9 per 100,000 population among Black individuals in West Virginia, significantly higher than the rate of 56.3 among Black individuals nationally, and not significantly different than the rate of 77.2 among white individuals in West Virginia.
- The five-year survival rate is 21.3% among Black individuals in West Virginia, not significantly different than the rate of 23.8% among Black individuals nationally, and not significantly different than the rate of 22.3% among white individuals in West Virginia.
- 25.5% of lung cancer cases are diagnosed at an early stage among Black individuals in West Virginia, not significantly different than the rate of 23.2% among Black individuals nationally, and not significantly different than the rate of 26.7% among white individuals in West Virginia.
- 21.1% of Black individuals with lung cancer in West Virginia underwent surgery, not significantly different than the rate of 17.0% among Black individuals nationally, and not significantly different than the rate of 20.3% among white individuals in West Virginia.
- 17.1% of Black individuals with lung cancer in West Virginia did not receive any treatment, significantly lower than the rate of 22.4% among Black individuals nationally, and not significantly different than the rate of 21.7% among white individuals in West Virginia.
Latino individuals:
- The rate of new lung cancer cases is 19.1 per 100,000 population among Latino individuals in West Virginia, not significantly different than the rate of 28.2 among Latino individuals nationally, and significantly lower than the rate of 77.2 among white individuals in West Virginia.
- 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.
- Other lung cancer rates are not available for Latino individuals in West Virginia due to too few cases over the time period to allow for accurate analysis.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 26.3 per 100,000 population among Asian or Pacific Islanders individuals in West Virginia, not significantly different than the rate of 32.9 among Asian or Pacific Islanders individuals nationally, and significantly lower than the rate of 77.2 among white individuals in West Virginia.
- 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.
- Other lung cancer rates are not available for Asian or Pacific Islander individuals in West Virginia due to too few cases over the time period to allow for accurate analysis.
Indigenous Peoples:
- Lung cancer rates are not available for Indigenous Peoples (American Indians/Alaska Natives) in West Virginia due to too few cases over the time period to allow for accurate analysis.
Summary
Despite the early diagnosis rate in West Virginia 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.
West Virginia 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.
West Virginia falls into the 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.