The purpose of this study was to explore factors, other than patient knowledge, that might explain low use of cervical and breast cancer screening among Hispanic women. A questionnaire was used to assess knowledge of screening recommendations and self-reported adherence among 70 older Hispanic women in Texas. Most had high knowledge levels, but this did not predict adherence. Fourteen women, all with high knowledge levels, also answered a semi-structured qualitative interview. Barriers to screening discussed in qualitative interviews included transportation, time, cost, and believing screening to be unnecessary following previous negative screening, or when sexual activity is absent. Reminders and referrals from primary care providers were key to reported adherence. Establishing policies and procedures to assure consistent cancer screening reminders and referrals may improve rates of cancer screening among women similar to those in our study, especially in settings where there is little opportunity to develop long-term patient-provider relationships.

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