January 2023
Delivering Quality Care: Cervical and Breast Cancer Screenings
The new year is an opportunity to remind our members to schedule screenings for cervical cancer and breast cancer. Regular screening tests can detect problems early when they’re easier to treat.
Recommended Screenings
- Screening all women for cervical cancer starting at age 21
- Screening women ages 50-74 for breast cancer every two years. You may want to discuss with members the risks and benefits of starting screening mammograms before age 50.
See our preventive care guidelines for more information.
Addressing Health Disparities
According to the American Cancer Society:
- Native American and Hispanic women have the highest rates of cervical cancer.
- Black women are more likely to die from breast and cervical cancer than other racial or ethnic groups. Learn more about disparities in breast cancer.
Other non-medical drivers of health, such as education levels and poverty, are also linked to different health outcomes. See our Health Equity and Social Determinants of Health page for more information on health equity and how you can help.
Closing Gaps in Care
Cervical cancer screening and breast cancer screening are Healthcare Effectiveness Data Information Set (HEDIS®) measures developed by the National Committee for Quality Assurance (NCQA). We track data from HEDIS measures to help assess and improve our members’ care.
Cervical cancer screening tracks the following:
- Women ages 21-64 who had cervical cytology performed within the last 3 years
- Women ages 30- 64 who had either:
- Cervical high-risk human papillomavirus (hrHPV) testing within the last 5 years or
- Cervical cytology/hrHPV cotesting within the last 5 years
Breast cancer screening assesses the percentage of women ages 50-74 who had at least one mammogram in the past two years.
Tips to Consider
- Talk with our members about risk reduction and prevention.
- We’ve created resources on cervical cancer and breast cancer screening that may help.
- The Centers for Disease Control and Prevention recommends human papillomavirus (HPV) vaccines for all people up to age 26 to protect against cervical cancers. We have a tip sheet on coding and documenting for HPV and related cancers.
- Document screenings in the medical record. Indicate the date and result.
- Document medical and surgical history in the medical record, including dates.
- For members who have had a hysterectomy, document the type of hysterectomy and date. Discuss with our members they may continue to need cervical cancer screening after their hysterectomy, depending on the procedure previously performed.
- Follow up with members if they miss their appointment and help them reschedule.
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.
HEDIS is a registered trademark of NCQA.