Stay Informed: Updates to Breast and Cervical Cancer Screenings
The Women’s Preventive Services Initiative (WPSI) is updating its recommendations to make preventive screenings more helpful and accessible.
Background
The WPSI recommends that patients at average risk of breast cancer have a mammogram between the ages of 40 and 50. Screening should occur at least every other year and potentially annually.
WPSI also recommends cervical cancer screening for average-risk patients aged 21 to 65. Most people should be screened every 3 to 5 years.
What’s changing?
Breast cancer screenings will be expanded to include:
- Additional imaging, such as MRI, ultrasound, and mammogram
- Pathology evaluation, such as biopsies and consultations
- Patient navigation services
Cervical cancer screenings will be expanded to include:
- Patient navigation services
When will these changes happen?
The new requirements start on January 1, 2026.
What are patient navigation services?
Patient navigation services are meant to make healthcare easier for people to access, especially for those with complex conditions like cancer. A patient navigator helps you get the care and support you need, whether face-to-face, online, or through a mixture of both methods.
These services include but aren’t limited to:
- Person-centered assessment and planning
- Healthcare access and health system navigation
- Referrals to support services, such as language translation, transportation, and social services
- Patient education
Which lines of business and market segments are included?
- Fully insured, self-funded, and OptiFlex
- Applies to Washington and Alaska
- This federal preventive benefit can’t be opted out of
- Grandfathered plans are out of scope