Wisconsin
Fee-For-Service Medicaid Coverage of Screening
Covered and Using Updated Guidelines
Highlighted Disparity
Indigenous Peoples in Wisconsin are most likely to be diagnosed with lung cancer.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 57.5 and significantly higher than the national rate of 54.6.
- Wisconsin ranks 28th among all states, placing it in the average tier.
- Over the last five years, the rate of new cases in Wisconsin improved by 16%..
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Wisconsin is 27.4%, which is not significantly different than the national rate of 26.6%.
- It ranks 16th among the 42 states with survival data, placing it in the average tier.
- Over the last five years, the survival rate in Wisconsin improved by 23%.
Early Diagnosis:
- 28.3% of cases are caught at an early stage, which is significantly higher than the national rate of 26.6%.
- It ranks 12th among the 47 states with data on diagnosis at an early stage, placing it in the above average tier.
- Over the last five years, the early diagnosis rate in Wisconsin did not change signficantly.
Lung Cancer Treatment
Surgical Treatment:
- Wisconsin ranked 14th (out of the 47 states with available data) with 21.9% 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 Wisconsin in the average tier.
- Over the last five years, the percent of cases undergoing surgery in Wisconsin did not change significantly.
Lack of Treatment:
- Wisconsin 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 Wisconsin in the above average tier.
- Over the last five years, the percent of cases receiving no treatment in Wisconsin did not change significantly.
Screening
Screening for High Risk:
- In Wisconsin, 7.3% of those at high risk were screened, which was significantly higher than the national rate of 4.5%.
- It ranks 9th among all states, placing it in the above average tier.
- Actual screening rates may be higher in states with large, regional managed care providers that did not share screening data.
Medicaid Coverage:
- Wisconsin 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 Wisconsin is 13.3% and not significantly different than the national rate of 13.5%.
- It ranks 19th among all states, placing it in the average tier.
Radon:
- In Wisconsin, 46.4% of radon tests results were at or above the action level recommended by EPA.
- It ranks 46th among all states, placing it in the bottom tier.
Racial & Ethnic Disparities
Black individuals:
- The rate of new lung cancer cases is 87.8 per 100,000 population among Black individuals in Wisconsin, significantly higher than the rate of 56.3 among Black individuals nationally, and significantly higher than the rate of 57.0 among white individuals in Wisconsin.
- The five-year survival rate is 27.8% among Black individuals in Wisconsin, not significantly different than the rate of 23.8% among Black individuals nationally, and not significantly different than the rate of 27.5% among white individuals in Wisconsin.
- 25.9% of lung cancer cases are diagnosed at an early stage among Black individuals in Wisconsin, not significantly different than the rate of 23.2% among Black individuals nationally, and not significantly different than the rate of 28.5% among white individuals in Wisconsin.
- 20.6% of Black individuals with lung cancer in Wisconsin underwent surgery, significantly higher than the rate of 17.0% among Black individuals nationally, and significantly lower than the rate of 22.1% among white individuals in Wisconsin.
- 18.4% of Black individuals with lung cancer in Wisconsin 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 17.3% among white individuals in Wisconsin.
Latino individuals:
- Lung cancer rates are not available for Latino individuals in Wisconsin 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 30.9 per 100,000 population among Asian or Pacific Islanders individuals in Wisconsin, not significantly different than the rate of 32.9 among Asian or Pacific Islanders individuals nationally, and significantly lower than the rate of 57.0 among white individuals in Wisconsin.
- 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.
- 24.7% of lung cancer cases are diagnosed at an early stage among Asian or Pacific Islander individuals in Wisconsin, not significantly different than the rate of 22.8% among Asian or Pacific Islander individuals nationally, and not significantly different than the rate of 28.5% among white individuals in Wisconsin.
- 17.1% of Asian or Pacific Islander individuals with lung cancer in Wisconsin underwent surgery, significantly lower than the rate of 24.7% among Asian or Pacific Islander individuals nationally, and not significantly different than the rate of 22.1% among white individuals in Wisconsin.
- 21.2% of Asian or Pacific Islander individuals with lung cancer in Wisconsin did not receive any treatment, not significantly different than the rate of 20.2% among Asian or Pacific Islander individuals nationally, and not significantly different than the rate of 17.3% among white individuals in Wisconsin.
Indigenous Peoples:
- The rate of new lung cancer cases is 89.9 per 100,000 population among Indigenous Peoples (American Indians/Alaska Natives) in Wisconsin, significantly higher than the rate of 39.4 among Indigenous Peoples nationally, and significantly higher than the rate of 57.0 among white individuals in Wisconsin.
- 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.
- 28.2% of lung cancer cases are diagnosed at an early stage among Indigenous Peoples (American Indians/Alaska Natives) in Wisconsin, not significantly different than the rate of 23.5% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and not significantly different than the rate of 28.5% among white individuals in Wisconsin.
- 14.7% of Indigenous Peoples (American Indians/Alaska Natives) with lung cancer in Wisconsin underwent surgery, not significantly different than the rate of 16.3% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and significantly lower than the rate of 22.1% among white individuals in Wisconsin.
- 18.7% of Indigenous Peoples (American Indians/Alaska Natives) with lung cancer in Wisconsin did not receive any treatment, not significantly different than the rate of 23.2% among Indigenous Peoples (American Indians/Alaska Natives) nationally, and not significantly different than the rate of 17.3% among white individuals in Wisconsin.
Summary
Despite the early diagnosis rate in Wisconsin falling into the above 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.
Wisconsin 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.
Wisconsin 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.