In the South, especially Appalachia, the incidence of invasive cervical cancer has remained high relative to the rest of the United States. Populous Florida now stands third among states by incidence and fifth from last in Pap screening. During the 1994 survey, 2,059 Florida women chosen as a multi-stage cluster sample were interviewed concerning their use of screening Pap smears. Never-participation in screening percentages were significantly higher in Hispanic women (14.7%), those sharing household incomes of less than $10,000 (13.2%), and women limited to a high school education (10.7%), but not among respondents older than 64 years of age (8.7%). Despite continued annual physician contact by most, yearly Pap smears fell to only 57.0% among women aged 55-64 years. It is important that physicians target these women and use any appropriate clinical contact to educate them about risk factors for cervical cancer while encouraging regular, continued use of this life-saving test.