A screening looks for cancer before you have any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread.

Scientists are trying to better understand which people are more likely to get certain types of cancer. They also study the things we do and the things around us to see if they cause cancer. This information helps doctors recommend who should be screened for cancer, which screening tests should be used and how often the tests should be done.

Important disclaimer

It is important for beneficiaries to use network providers for services whenever possible. Prime beneficiaries must have an approved referral on file before receiving clinical preventive services (including colorectal screenings) from a non-network provider, or Point of Service (POS) will apply.

Cologuard™ referral is no longer required for TRICARE Prime beneficiaries. If your physician provides you with Cologuard™, a referral is no longer required prior to testing.

Breast screenings Cervical screenings Colorectal screenings Diabetes screenings

Are breast cancer screenings covered?

TRICARE covers annual mammograms for all women who are age 40 or older and for women age 30 or older who are at a 15% or greater lifetime risk of developing breast cancer. The National Cancer Institute (NCI) and the National Surgical Adjuvant Breast and Bowel Project (NSABP) have developed a risk assessment tool to estimate a woman's risk of developing invasive breast cancer.

What are the signs and symptoms of breast cancer?

The most common symptom of breast cancer is a new lump or mass. It is important to have any new breast mass, lump or breast change checked by a healthcare professional experienced in diagnosing breast diseases.

Other possible symptoms include:

  • Swelling of all or part of a breast (even if no distinct lump is felt)
  • Skin irritation or dimpling (sometimes looking like an orange peel)
  • Breast or nipple pain
  • Nipple retraction (turning inward)
  • Redness, scaliness, or thickening of the nipple or breast skin
  • Nipple discharge (other than breast milk)

Am I at risk?

The most common symptom of breast cancer is a new lump or mass. It is important to have any new breast mass, lump or breast change checked by a healthcare professional experienced in diagnosing breast diseases.

The following are risk factors for breast cancer: 

  • Drinking alcohol
  • Being overweight or obese
  • Being a breast cancer of survivor
  • Having a history of breast cancer in your family
  • Not being physically active
  • Not having children

When should I get a screening?

You should get a breast screening if you are: 

  • Age 40-49: Talk to your provider about when to start and how often to get a mammogram 
  • Age 50-74: For women with an average risk for breast cancer, a mammogram every two years is recommended

Cervical cancer is the easiest gynecologic cancer to prevent with regular screening tests and follow-ups. Two screening tests can help prevent cervical cancer or find it early are:

  • Pap test (or Pap smear): looks for any cell changes on the cervix that might become cervical cancer if they are not treated appropriately
  • HPV test: looks for Human Papillomavirus that can cause these cell changes

Are cervical cancer screenings covered?

Cervical cancer is the easiest gynecologic cancer to prevent with regular screening tests and follow-ups. TRICARE covers the following to screen for cervical cancer:

  • Physical examination (Pelvic examination should be performed in conjunction with Pap smear testing)
  • Pap Smear testing for women 21 years of age or older
  • Human Papillomavirus (HPV) Deoxyribonucleic Acid (DNA) testing when performed in conjunction with a Pap smear and only for women 30 and older

What are the signs and symptoms of cervical cancer?

In the early stages of cervical cancer, there may not be any symptoms at all. In some cases, the symptoms may be irregular or heavy pain or bleeding.

Am I at risk?

The following conditions can be risk factors for cervical cancer:

  • Human Papillomavirus (HPV) infection
  • Smoking
  • A weakened immune system
  • Chlamydia infection
  • A diet low in fruits and vegetables
  • Being overweight
  • Long-term use of oral contraceptives (birth control pills)
  • Having multiple full-term pregnancies
  • Young age at first full-term pregnancy

When should I get a screening?

The American Cancer Society recommends that cervical cancer screening begin at age 25.

Those aged 25 to 65 should have a primary HPV test every five years. If primary HPV testing is not available, screening may be done with either a co-test that combines an HPV test with a Papanicolaou (Pap) test every five years or a Pap test alone every three years.

Those over age 65 who have had regular screening in the past 10 years with normal results and no history of CIN2 or more serious diagnosis within the past 25 years should stop cervical cancer screening. Once stopped, it should not be started again.

Women who have had a total hysterectomy (removal of the uterus and cervix) should stop screening, unless the hysterectomy was done as a treatment for cervical cancer or serious pre-cancer. Those who have had a hysterectomy without removal of the cervix (called a supra-cervical hysterectomy) should continue cervical cancer screening according to the guidelines above.

Those who have been vaccinated against HPV should still follow these guidelines for their age groups.

Are colorectal cancer screenings covered?

TRICARE covers the following based on your risk factor.

Average risk:

  • Starting screening at age 45
  • Fecal Occult Blood Test (FOBT) once every (12 months) (includes: guaiac (gFOBT) and Fecal Immunochemical Test (FIT))
  • Flexible sigmoidoscopy every five years (60 months)
  • CT colonography every five years (60 months)
  • FIT-DNA test every one to three years (12 to 36 months)
  • Colonoscopy every ten years (120 months)

Increased risk:

  • One or more first degree relatives diagnosed with sporadic colorectal cancer or an adenomatous polyp before the age of 60 or in two or more first degree relatives at any age.
  • What's covered: Optical colonoscopy every three to five years. This begins at age 40 or 10 years earlier than the youngest affected relative, whichever is earlier.
  • One or more first degree relatives diagnosed with sporadic colorectal cancer or an adenomatous polyp at age 60 or older, or two second-degree relatives diagnosed with colon cancer.
  • What's covered: Flexible sigmoidoscopy (once every five years) or optical colonoscopy (once every 10 years). This begins at age 40 or 10 years earlier than the youngest affected relative, whichever is earlier.

High risk:

  • Known or suspected Familial Adenomatous Polyposis (FAP).
  • What's covered: Flexible sigmoidoscopy annually beginning at age 10 to 12.
  • Family history of Hereditary Non-Polyposis Colorectal Cancer (HNPCC) syndrome.
  • What's covered: Optical colonoscopy once every one to two years. This begins at age 20 to 25, or 10 years younger than the earliest age of diagnosis of colorectal cancer, whichever is earlier.
  • Inflammatory Bowel Disease (IBD), Chronic Ulcerative Colitis (CUC), or Crohn's disease.

What's covered: Your cancer risk begins to be significant eight years after the onset of pancolitis or 10 to 12 years after the onset of left-sided colitis. If you have these risk factors, then you should get an optical colonoscopy every one to two years with biopsies for dysplasia.

This list of covered services is not all inclusive. TRICARE covers services that are medically necessary and considered proven. There are special rules or limits on certain services and some services are excluded.

What are some of the signs and symptoms?

  • Blood in or on your stool
  • Stomach pain, aches, or cramps that do not go away
  • Unexplained weight loss
  • A change in bowel habits

Am I at risk?

More than 90% of colorectal cancer occurs in people who are 50 years old or older. Other risk factors include:

  • Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis
  • Personal or family history of colorectal cancer or colorectal polyps
  • Lack of regular physical activity
  • A diet low in fruits and vegetables
  • Low-fiber and high-fat diet
  • Being overweight or obese
  • Alcohol consumption
  • Tobacco use

Are diabetes screenings covered?

Your PCM determines whether you should get a screening. Talk to your provider about your risk factors and/or any symptoms you may be experiencing.

What is the A1C test?

According to the American Diabetes Association, A1C tests are used to identify prediabetes, diagnose diabetes and monitor how well diabetes treatment is working. The test results give you a picture of your average blood sugar level over the past two to three months. The higher the levels, the greater your risk of developing diabetes complications.

What are the signs and symptoms?

If you experience any of the following symptoms, you may need to see your provider to get your blood sugar checked:

  • Urinate a lot, often at night
  • Extreme thirst or hunger
  • Lose weight without trying
  • Blurry vision
  • Numbness or tingling in hands or feet
  • Fatigue
  • Dry skin
  • Sores that heal slowly
  • Have more infections than usual

Am I at risk?

The following are risk factors for diabetes:

  • Overweight or obese
  • Age 45 or older
  • Have a parent or sibling with Type 2 diabetes
  • Have low High-Density Lipoprotein (HDL) cholesterol and/or high triglycerides
  • Physically active less than three times a week
  • Have high blood pressure or take medication for high blood pressure
  • Had gestational diabetes or given birth to a baby weighing over nine pounds
  • Are African American, Hispanic/Latino American, American Indian, Pacific Islander or Alaska native
  • Have been diagnosed with Polycystic Ovary Syndrome (PCOS)