Definitions of Terms

Burden of Lung Cancer

The impact of the disease on states as measured by the key indicators.

Early Diagnosis

The percent of lung cancer cases diagnosed at an early stage, before the tumor has spread. See Stage at Diagnosis.

High Risk

Those at high risk for lung cancer and recommended for annual screening with low dose CT scan are defined as: 

• 50-80 years of age 

• Have a 20 pack-year history (1 pack/day for 20 years, 2 packs/day for 10 years) 

• AND, are a current smoker, or have quit within the last 15 years 

This criteria for high risk is set by the U.S. Preventative Services Task Force (USPSTF). There are other risk factors to consider as well, such as exposure to radon gas, air pollution and secondhand smoke, and sometimes a person is genetically pre-disposed to be at risk for lung cancer. However, “high risk” in this report is defined by the criteria set by USPSTF. 

Based on new research, in March 2021, the USPSTF expanded its recommendation for screening to include a lower age range of 50 years and pack-year history of 20.

Key Indicators

The factors measured for this report: new cases, early diagnosis, survival, surgical treatment, lack of treatment, screening among those at high risk, and coverage of screening by fee-for-service Medicaid by state.

Lack of Treatment

The percent of patients who did not receive any form of treatment for lung cancer after their diagnosis. 

New Cases

The number of new lung cancer cases diagnosed each year per 100,000 people. An incidence rate of 71 per 100,000 in North Carolina (population 10 million) would mean about 7,100 new cases were diagnosed in that state each year. 

Requires Insurance Coverage of Biomarker Testing

Whether a state requires all healthcare plans to cover comprehensive biomarker testing, only some plans, or not at all. 

Screening Rate

The percent of those at high risk for lung cancer who were screened using low dose CT in 2022.

Smoking Rate

Percent of adults who are current smokers, meaning they have ever smoked 100 cigarettes or more and currently smoke some days or every day.

Stage at Diagnosis

Lung cancer stage is determined by a combination of factors: where the lung cancer cells are located, the size of the lung cancer tumor, and if and where the lung cancer has spread. Cases described as diagnosed at an early stage are generally equivalent to stage I. Cases described as diagnosed at a late stage are generally equivalent to stage IV.

Surgical Treatment

Surgery for lung cancer involves removing part of or the entire lung to get rid of the tumor/diseased lung tissue and indicates that lung cancer was caught early and unlikely to have spread. 

Survival Rate

The percent of people still alive five years after being diagnosed with lung cancer. 

Tier

How the rate for a state compares to the national rate and other states. Top tier is the best and bottom tier is the worst.