Patient Navigation Services for Breast and Cervical Cancer Screening

The Women’s Preventive Services Initiative recommends patient navigation services for breast and cervical cancer screening  and follow-up, as relevant, to increase utilization of screening recommendations based on an assessment of the patient’s needs for navigation services. Patient navigation services involve person-to-person (eg, in-person, virtual, hybrid models) contact with the patient. Components of patient navigation services should be individualized. Services include, but are not limited to, person-centered assessment and planning, health care access and health system navigation, referrals to appropriate support services (eg, language translation, transportation, and social services), and patient education.

Patient navigation services may be provided by support staff in specific clinical settings or centralized within health systems. Patient navigators provide services to help guide the patient through their course of care, including any unmet social needs that significantly limit the clinician’s ability to deliver recommended breast and cervical cancer screening and follow-up. Services include the following activities:

• Person-centered assessment and planning to understand the patient’s barriers to effective breast and cervical cancer screening and follow-up, including understanding cultural and linguistic factors as well as unmet social determinants of health needs.
• Health care access and health system navigation to help the patient access care, including identifying appropriate services and providers for breast and cervical cancer screening and follow-up care and securing appointments with them.
• Identifying or referring the patient to appropriate support services, such as language translation, transportation, and social services, among others.
• Patient education to help the patient understand breast and cervical cancer screening and follow-up and to improve their ability to interact with the health care team.

The clinician initiates patient navigation services when they identify the patient’s need for facilitation of breast and cervical cancer screening and follow-up, as relevant. Clinicians may provide or refer for the subsequent navigation services that support staff may provide. Personal interaction is vital to successful navigation services and should be culturally and linguistically appropriate to reduce health disparities.

• Additional randomized controlled trials of patient navigation to improve screening and follow-up for breast and cervical cancer screening among women at risk of experiencing health disparities (eg, due to race, ethnicity, sexual orientation, gender identity, socioeconomic status, geography, preferred language, and other factors that affect access to care and health outcomes). 
• Studies evaluating barriers to accessing screening or follow up for breast and cervical cancer screening.
• Comparative effectiveness trials of patient navigation services for breast and cervical cancer screening based on type of delivery (eg, in-person, virtual), intensity (eg, frequency, duration), services needed (eg, language, transportation, social services), and type of navigator (eg, telephone counselor, lay health worker, promotora, clinician, etc.).