BACKGROUND The purpose of this study was to explore attitudes, beliefs, and perceived barriers to risk-based cervical cancer screening through focus group interviews of patients. METHODS We conducted 8 focus group interviews of women using semistructured interviews. The investigators independently reviewed the focus group transcripts and identified the overall themes and themes unique to each question using an immersion and crystallization approach. RESULTS Women are in agreement that cervical cancer screening is important and that women should get Pap smears regularly as an important way of protecting their health. They are not open to the idea of reducing the frequency of Papanicolaou (Pap) smears, however, because they perceive annual screening to be successful in reducing cervical cancer mortality. Additionally, they have concerns about test accuracy. Women are distrustful of the rationale for reducing the frequency of Pap smears. Women's previous bad experiences have reinforced their need for self-advocacy. CONCLUSIONS Women are reluctant to engage in risk-based cervical cancer screening. In this environment, risk-based cervical cancer screening recommendations are likely to be met with resistance.