The approaches used to ensure regular Pap testing must be tailored to sociodemographic, psychosocial, medical, and motivational factors that may change over a woman's life. Careful descriptions of the determinants of Pap testing at different stages are needed; the success of Pap-emphasizing programs designed without this information may be severely limited. We review the literature on demographic and psychosocial correlates of Pap testing and on the relationship of Pap smear frequency to contact with the medical care system and to preventive health behaviors. We include a discussion of factors related to preventive health behavior in general, so that the Pap test can be viewed against a range of behaviors. Pap program efforts must focus more precisely; our review of the available literature provides recommendations for improving Pap screening programs.