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 78 and significantly higher than the national rate of 57.
- West Virginia ranks 50th among all states, placing it in the bottom tier.
- Over the last five years, the rate of new cases in West Virginia improved by 9%.
5-Year Survival Rate:
- The percent of people alive five years after being diagnosed with lung cancer (the survival rate) in West Virginia is 20%, which is significantly lower than the national rate of 25%.
- It ranks 42nd among the 46 states with survival data, placing it in the bottom tier.
- Over the last five years, the survival rate in West Virginia improved by 11%.
Early Diagnosis:
- 26% of cases are caught at an early stage, which is not significantly different than the national rate of 26%.
- It ranks 23rd 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 did not change significantly.
Lung Cancer Treatment
Surgical Treatment:
- West Virginia ranked 26th (out of the 49 states with available data) with 20% of cases undergoing surgery as part of the first course of treatment.
- This is significantly lower than the national rate of 21% and puts West Virginia in the average tier.
- Over the last five years, the percent of cases undergoing surgery in West Virginia improved by 22%.
Lack of Treatment:
- West Virginia ranked 33rd (out of the 49 states with available data) with 22% of cases not receiving any treatment.
- This is not significantly different than the national rate of 21% 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% of those at high risk were screened, which was significantly lower than the national rate of 6%.
- It ranks 37th among all states, placing it in the below average tier.
- 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 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 West Virginia is 23% and significantly higher than the national rate of 14%.
- It ranks 51st among all states, placing it in the bottom tier.
Radon:
- In West Virginia, 29% 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 Americans:
- The rate of new lung cancer cases is 68 per 100,000 population among Black Americans in West Virginia, not significantly different than the rate of 59 among Black Americans nationally, and significantly lower than the rate of 79 among whites in West Virginia.
- The five-year survival rate is 18% among Black Americans in West Virginia, not significantly different than the rate of 22% among Black Americans nationally, and not significantly different than the rate of 20% among whites in West Virginia.
- 24% of lung cancer cases are diagnosed at an early stage among Black Americans in West Virginia, not significantly different than the rate of 23% among Black Americans nationally, and not significantly different than the rate of 26% among whites in West Virginia.
- 21% of Black Americans with lung cancer in West Virginia underwent surgery, not significantly different than the rate of 17% among Black Americans nationally, and not significantly different than the rate of 20% among whites in West Virginia.
- 20% of Black Americans with lung cancer in West Virginia did not receive any treatment, not significantly different than the rate of 22% among Black Americans nationally, and not significantly different than the rate of 22% among whites in West Virginia.
Latino Americans:
- Lung cancer rates are not available for Latino Americans 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 25 per 100,000 population among Asian Americans or Pacific Islanders in West Virginia, not significantly different than the rate of 34 among Asian Americans or Pacific Islanders nationally, and significantly lower than the rate of 79 among whites in West Virginia.
- 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 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.