Rhode Island
Fee-For-Service Medicaid Coverage of Screening
Covered and Using Updated Guidelines
Highlighted Disparity
No racial disparities were found in Rhode Island for these lung cancer metrics.
Lung Cancer Rates
New Cases:
- The rate of new lung cancer cases is 68 and significantly higher than the national rate of 57.
- Rhode Island ranks 43rd among all states, placing it in the below average tier.
- Over the last five years, the rate of new cases improved by 13%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in Rhode Island is 31%, which is significantly higher than the national rate of 25%.
- It ranks 1st among the 46 states with survival data, placing it in the top tier.
- Over the last five years, the survival rate in Rhode Island improved by 29%.
Early Diagnosis:
- 30% of cases are caught at an early stage, which is significantly higher than the national rate of 26%.
- It ranks 3rd among the 49 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 Rhode Island improved by 38%.
Lung Cancer Treatment
Surgical Treatment:
- Rhode Island ranked 3rd (out of the 49 states with available data) with 28% of cases undergoing surgery as part of the first course of treatment.
- This is significantly higher than the national rate of 21% and puts Rhode Island in the top tier.
- Over the last five years, the percent of cases undergoing surgery in Rhode Island did not change significantly.
Lack of Treatment:
- Rhode Island ranked 2nd (out of the 49 states with available data) with 15% of cases not receiving any treatment.
- This is significantly lower than the national rate of 21% and puts Rhode Island in the top tier.
- Over the last five years, the percent of cases receiving no treatment in Rhode Island did not change significantly.
Screening
Screening for High Risk:
- In Rhode Island, 13% of those at high risk were screened, which was significantly higher than the national rate of 6%.
- It ranks 2nd among all states, placing it in the top tier.
- Screening rates may be higher in states with large, regional managed care providers that did not share screening data.
Medicaid Coverage:
- Rhode Island was one of the 46 states whose Medicaid fee-for-service programs covered lung cancer screening as of July 2022.
- 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 Rhode Island is 14% and not significantly different than the national rate of 14%.
- It ranks 17th among all states, placing it in the average tier.
Radon:
- In Rhode Island, 21% of radon tests results were at or above the action level recommended by EPA.
- It ranks 22nd among all states, placing it in the average tier.
Racial & Ethnic Disparities
Black Americans:
- The rate of new lung cancer cases is 58 per 100,000 population among Black Americans in Rhode Island, not significantly different than the rate of 59 among Black Americans nationally, and significantly lower than the rate of 72 among whites in Rhode Island.
- The five-year survival rate is 32% among Black Americans in Rhode Island, significantly higher than the rate of 22% among Black Americans nationally, and not significantly different than the rate of 31% among whites in Rhode Island.
- 32% of lung cancer cases are diagnosed at an early stage among Black Americans in Rhode Island, significantly higher than the rate of 23% among Black Americans nationally, and not significantly different than the rate of 30% among whites in Rhode Island.
- 29% of Black Americans with lung cancer in Rhode Island underwent surgery, not significantly different than the rate of 17% among Black Americans nationally, and not significantly different than the rate of 29% among whites in Rhode Island.
- Other lung cancer rates are not available for Black Americans in Rhode Island due to too few cases over the time period to allow for accurate analysis.
Latino Americans:
- The rate of new lung cancer cases is 35 per 100,000 population among Latinos in Rhode Island, not significantly different than the rate of 29 among Latinos nationally, and significantly lower than the rate of 72 among whites in Rhode Island.
- State-level survival rates are not available for Latino Americans at this time. Nationally, the five-year survival rate among Latino Americans is 19%, 25% lower than among white Americans.
- 30% of lung cancer cases are diagnosed at an early stage among Latinos in Rhode Island, not significantly different than the rate of 23% among Latinos nationally, and not significantly different than the rate of 30% among whites in Rhode Island.
- 23% of Latinos with lung cancer in Rhode Island underwent surgery, not significantly different than the rate of 22% among Latinos nationally, and not significantly different than the rate of 29% among whites in Rhode Island.
- 14% of Latinos with lung cancer in Rhode Island did not receive any treatment, significantly lower than the rate of 26% among Latinos nationally, and not significantly different than the rate of 14% among whites in Rhode Island.
Asian Americans or Pacific Islanders:
- The rate of new lung cancer cases is 33 per 100,000 population among Asian Americans or Pacific Islanders in Rhode Island, not significantly different than the rate of 34 among Asian Americans or Pacific Islanders nationally, and significantly lower than the rate of 72 among whites in Rhode Island.
- 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% and not significantly different than among white Americans.
- Other lung cancer rates are not available for Asian Americans or Pacific Islanders in Rhode Island 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 Rhode Island due to too few cases over the time period to allow for accurate analysis.
Summary
Despite the early diagnosis rate in Rhode Island falling into the top 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.
Rhode Island 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.
Rhode Island falls into the top 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.