District of Columbia
Requires Coverage of Comprehensive Biomarker Testing
No
Highlighted Disparity
Black individuals in the District of Columbia are most likely to be diagnosed with lung cancer
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases in the District of Columbia is 44.7 and significantly lower than the national rate of 52.8.
- The District of Columbia ranks 10th among all states, placing it in the above average tier.
- Over the last five years, the rate of new cases in the District of Columbia improved by 18%.
- In 2022, the most recent year of data available for this report, the COVID-19 pandemic continued to disrupt access to medical care, including delays and reductions in cancer diagnoses and screening. This led to a decline in incidence rates for most cancers, including lung cancer, and should not be interpreted as a reduction in the underlying cancer burden.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer is 29.7% nationally. The District of Columbia is one of the 12 states for which survival data is not available as they do not track cases after diagnosis.
Early Diagnosis:
- In the District of Columbia, 28.3% of cases are caught at an early stage, which is not significantly different than the national rate of 28.1%.
- It ranks 27th among the 50 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 the District of Columbia did not change significantly.
Lung Cancer Treatment
Surgical Treatment:
- The District of Columbia ranked 24th (out of the 49 states with available data) with 19.7% of cases undergoing surgery as part of the first course of treatment.
- This is not significantly different than the national rate of 20.7% and puts the District of Columbia in the average tier.
- Over the last five years, the percent of cases undergoing surgery in the District of Columbia did not change significantly.
Biomarker Coverage:
- The District of Columbia has yet to require any insurance coverage of comprehensive biomarker testing, including for lung cancer, as of August 2025.
No Treatment:
- The District of Columbia ranked 40th (out of the 49 states with available data) with 23.9% of cases not receiving any treatment.
- This is significantly higher than the national rate of 21.0% and puts the District of Columbia in the average tier.
- Over the last five years, the percent of cases receiving no treatment in the District of Columbia did not change significantly.
Screening
Screening for High Risk:
- In the District of Columbia, 25.3% of those at high risk were screened, which was not significantly different than the national rate of 18.2%.
- It ranks 4th among all states, placing it in the above average tier.
Prevention
Tobacco Use:
- The 2023 smoking rate in the District of Columbia is 9.8% and not significantly different than the national rate of 11.4%.
- It ranks 10th among all states, placing it in the above average tier.
Radon:
- In the District of Columbia, 8.7% of radon test results were at or above the action level recommended by EPA.
- It ranks 6th among all states, placing it in the top tier.
Racial & Ethnic Disparities
Black individuals:
- The rate of new lung cancer cases is 60.5 per 100,000 population among Black individuals in the District of Columbia, significantly higher than the rate of 54.2 among Black individuals nationally, and significantly higher than the rate of 26.1 among white individuals in the District of Columbia.
- Survival rates by race and ethnicity are not available for the District of Columbia at this time. Nationally, the five-year survival rate among Black individuals is 27.1%, 9% lower than among white Americans.
27.2% of lung cancer cases are diagnosed at an early stage among Black individuals in the District of Columbia, not significantly different than the rate of 25.1% among Black individuals nationally, and not significantly different than the rate of 33.9% among white individuals in the District of Columbia.
17.1% of Black individuals with lung cancer in the District of Columbia underwent surgery, not significantly different than the rate of 17.1% among Black individuals nationally, and significantly lower than the rate of 29.9% among white individuals in the District of Columbia.
26.1% of Black individuals with lung cancer in the District of Columbia did not receive any treatment, significantly higher than the rate of 22.7% among Black individuals nationally, and significantly higher than the rate of 17.4% among white individuals in the District of Columbia.
Latino individuals:
- The rate of new lung cancer cases is 17.3 per 100,000 population among Latino individuals in the District of Columbia, significantly lower than the rate of 27.9 among Latino individuals nationally, and significantly lower than the rate of 26.1 among white individuals in the District of Columbia.
- 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 the District of Columbia 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 24.1 per 100,000 population among Asian or Pacific Islanders individuals in the District of Columbia, not significantly different than the rate of 32.5 among Asian or Pacific Islanders individuals nationally, and not significantly different than the rate of 26.1 among white individuals in the District of Columbia.
- 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 the District of Columbia 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 the District of Columbia due to too few cases over the time period to allow for accurate analysis.
Summary
Despite the early diagnosis rate in the District of Columbia 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 District of Columbia has yet to require any insurance coverage of comprehensive biomarker testing, which can help determine what treatment options would be best for individuals with lung cancer and other diseases.
the District of Columbia 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.
Page last updated: October 1, 2025