Oatmeal Healthoatmealhealth.com · public-data estimate, October 2026

Sanford Health

Lung screening gap across 58 counties in Iowa, Minnesota, Montana, North Dakota and South Dakota

91,000to170,000adults in its service area qualify for lung cancer screening and are not being screened

About 1,800 people here are diagnosed with lung cancer each year, and 60% are found at a late stage, when it is hardest to treat.

Explore the screening network
WIMTMNIASDNENDWY
58 counties40 acute care hospitalsService areaShowing the Iowa, Minnesota, North Dakota and South Dakota region; all regions are mapped below.
110,000 to 210,000adults likely qualify under USPSTF 2021 criteria (estimate)
970lung cancer deaths a year in these counties, 2020 to 2024
18.6%of eligible adults screened in these states, vs 18.2% nationally

Estimates from public data only; no patient information. Sources and method below.

Where the eligible adults live

The counties where most of Sanford Health's Medicare inpatients live. Darker areas hold more adults who likely qualify, which is where outreach would start. Hover or tap any area for its estimate.

Iowa, Minnesota, North Dakota and South Dakota

Montana

Adults likely eligible, per neighborhood

0+160+200+240+280+320+390+

Acute care hospital in this system

Counties in the service area

CountyStateAdults likely eligibleLung cancer deaths per 100kMedicare screens billed locally, 2024
Hennepin CountyMinnesota42,200 to 87,20023.73,832
Minnehaha CountySouth Dakota8,500 to 14,10040.9837
Cass CountyNorth Dakota5,700 to 11,80028.7614
Burleigh CountyNorth Dakota3,700 to 7,60024.4474
Otter Tail CountyMinnesota3,700 to 5,40030.8None billed locally
Grand Forks CountyNorth Dakota2,100 to 4,70031.7253
Ward CountyNorth Dakota2,300 to 4,50029.6359
Lincoln CountySouth Dakota2,500 to 3,90026.5None billed locally
Clay CountyMinnesota2,400 to 3,90032.7None billed locally
Beltrami CountyMinnesota2,500 to 3,40031.978
Douglas CountyMinnesota2,100 to 3,30026.4None billed locally
Brown CountySouth Dakota1,700 to 3,20029.390
Cass CountyMinnesota2,400 to 3,00028.8None billed locally
Becker CountyMinnesota2,100 to 2,90028.538
Morton CountyNorth Dakota1,500 to 2,60025.1119
Polk CountyMinnesota1,500 to 2,50034.8None billed locally
Sioux CountyIowa1,300 to 2,40018.5None billed locally
Codington CountySouth Dakota1,600 to 2,30033.281
Stark CountyNorth Dakota1,300 to 2,20028.6None billed locally
Brookings CountySouth Dakota960 to 2,10031.8None billed locally
Hubbard CountyMinnesota1,300 to 2,10026.6None billed locally
Stutsman CountyNorth Dakota1,100 to 1,90028.6None billed locally
Lyon CountyMinnesota1,100 to 1,80038.5None billed locally
Nobles CountyMinnesota1,000 to 1,60029.7None billed locally
Richland CountyNorth Dakota740 to 1,40022.8None billed locally
Roseau CountyMinnesota870 to 1,30027.8None billed locally
Redwood CountyMinnesota850 to 1,30027.2None billed locally
Koochiching CountyMinnesota810 to 1,20026.0None billed locally
O'Brien CountyIowa750 to 1,20032.4None billed locally
Pennington CountyMinnesota720 to 1,10031.2None billed locally
McLean CountyNorth Dakota540 to 1,00020.3None billed locally
Roberts CountySouth Dakota700 to 1,00035.2None billed locally
Barnes CountyNorth Dakota530 to 1,00033.3None billed locally
Cottonwood CountyMinnesota600 to 95031.4None billed locally
Lyon CountyIowa600 to 90019.9None billed locally
Mercer CountyNorth Dakota480 to 87025.4None billed locally
Jackson CountyMinnesota520 to 87024.7None billed locally
Yellow Medicine CountyMinnesota550 to 84032.9None billed locally
Clay CountySouth Dakota430 to 81031.3None billed locally
Murray CountyMinnesota450 to 78021.5None billed locally
Clearwater CountyMinnesota570 to 76042.9None billed locally
Turner CountySouth Dakota450 to 76026.3None billed locally
Rock CountyMinnesota500 to 76038.3None billed locally
Traill CountyNorth Dakota330 to 710—None billed locally
Day CountySouth Dakota370 to 580—None billed locally
Norman CountyMinnesota380 to 57052.3None billed locally
Tripp CountySouth Dakota380 to 520—None billed locally
Wilkin CountyMinnesota370 to 52031.7None billed locally
Brule CountySouth Dakota300 to 510—None billed locally
Big Stone CountyMinnesota300 to 480—None billed locally
Mahnomen CountyMinnesota420 to 45087.2None billed locally
Gregory CountySouth Dakota250 to 410—None billed locally
Deuel CountySouth Dakota240 to 410—None billed locally
Corson CountySouth Dakota290 to 340—None billed locally
Traverse CountyMinnesota180 to 30051.9None billed locally
Perkins CountySouth Dakota180 to 270—None billed locally
Adams CountyNorth Dakota140 to 230—None billed locally
Liberty CountyMontana120 to 190—None billed locally

47 of the 58 counties had no Medicare lung screening reads billed from a local address in 2024. County names link to their Missing Millions page.

What closing the gap would mean

If screening in these counties rose from 18.6% to 23.6%, five points above today, about 5,600 to 10,300 more people would be screened each year.

In the National Lung Screening Trial, low-dose CT screening lowered lung cancer deaths by 20% compared with chest X-ray. Today about 60% of lung cancers here are found at a late stage.

Illustrative estimate: eligible adults (range) times the change in screening rate. Not a forecast or a guarantee.

Each year in these counties

1,800new lung cancers
1,100found at a late stage
970lung cancer deaths

NCI and CDC State Cancer Profiles, annual averages.

Screening at Sanford Health today

Clinicians at Sanford Health locations billed 1,180 low-dose CT lung screening reads to Medicare fee-for-service in 2024. Including Medicare Advantage and other insurers, we estimate about 2,300 to 6,400 screenings a year.

Most adults who qualify see a primary care clinician every year. We count 2,222 primary care clinicians, 21 pulmonologists and 4 thoracic surgeons practicing at Sanford Health locations. A 20 pack-year smoking history is often missing from structured EHR fields, so many eligible patients are never flagged.

CMS Medicare Physician and Other Practitioners 2024 (CPT 71271); clinicians matched to Sanford Health by practice address using the AHRQ Compendium of U.S. Health Systems 2023, so reads billed by outside radiology groups are not included. The all-payer estimate scales Medicare fee-for-service by the local Medicare Advantage share (48%, CMS) and, at the high end, by the share of eligible adults under 65 (64%).

40 acute care hospitals

  • Sanford Medical Center - FargoFargo, ND
  • Sanford Usd Medical CenterSioux Falls, SD
  • Sanford BismarckBismarck, ND
  • Sanford BemidjiBemidji, MN
  • Sanford Aberdeen Medical CenterAberdeen, SD
  • Sanford Worthington Medical CenterWorthington, MN
  • Coteau Des PrairiesSisseton, SD
  • Orange City Municipal HospitalOrange City, IA
  • Ortonville Area Health ServicesOrtonville, MN
  • Perham HealthPerham, MN
  • Sanford Bagley Medical CenterBagley, MN
  • Sanford Hospital CanbyCanby, MN

And 28 more acute care hospitals.

Find them, reach them, give radiologists a second opinion

LungIQ Find

Reads clinical notes, diagnoses and medications in the EHR and returns a ranked list of patients likely eligible, including those whose pack-year history is missing. Start with a CSV export refreshed every 1, 3 or 6 months, or connect through FHIR or HL7.

LungNAV Reach

An AI patient navigator that texts and calls patients in 70+ languages, answers questions about the scan, and hands each patient to your scheduling team or nurse navigators with a call summary.

LungAI Second opinion

Gives radiologists a malignancy risk score for each nodule, factoring in change since the prior scan, inside the PACS and CADe software they already use. The radiologist makes the final call.

LungAI is an investigational medical device and has not been cleared by FDA. It is not commercially available in the United States.

How we estimate the gap

Modeled estimates from public data. They are not a count of Sanford Health patients and contain no patient information.

  • Service area: CMS Hospital Service Area File 2025 (counties within 120 miles of a system hospital holding 80% of its Medicare inpatients, plus any county with at least 1%); hospitals from the AHRQ Compendium of U.S. Health Systems, 2023.
  • Eligible adults, low estimate: Oatmeal Health Missing Millions (Census 2025 population, CDC PLACES smoking, USPSTF 2021).
  • Eligible adults, high estimate: University of Minnesota National Lung Cancer Screening Estimates (Haynes 2026), which also counts former smokers.
  • Screening rate: American Lung Association, State of Lung Cancer 2025.
  • Lung cancer cases and deaths: NCI and CDC State Cancer Profiles (incidence 2019 to 2023, deaths 2020 to 2024).
  • Screening volume: CMS Medicare Physician and Other Practitioners, 2024; CMS Medicare Advantage State/County Penetration, September 2026.

LungAI is an investigational medical device and has not been cleared by FDA. Oatmeal Health is preparing a 510(k) premarket notification. LungAI is not commercially available in the United States.

See Sanford Health's own numbers

In a 30 minute review we replace these public estimates with counts from your own records and agree on what a first program would look like.

Request a private screening review