To explore the reasons why some older women do not have regular Papanicolaou smear tests. The Ballarat region of Victoria. Cross-sectional survey administered by telephone interview. Three hundred and forty-seven women aged 40 to 70. 1. 41% of women had not had a Papanicolaou smear test within the preceding 2 years. 2. Women who agreed with the statement that healthy women do not need to have Papanicolaou tests were six times more likely to be overdue for a Papanicolaou test than women who did not agree. 3. Being over 60 significantly increased the likelihood that a woman would be overdue for a Papanicolaou test, compared with younger women. 4. Women who thought that the test is only needed at intervals of 3 years or more were over six times more likely to be overdue than women who believed the interval to be 2 years or less. 5. Women who perceived themselves as being too embarrassed were nearly seven times more likely to be overdue than women who claimed no embarrassment. 6. Women who saw themselves as being too busy to have the test were three times more likely to be overdue than women who did not see themselves this way. 7. Women with a spouse were less likely to be overdue than other women. 8. Women who knew to start having Papanicolaou tests when they were sexually active were less likely to be overdue than women who did not know this. Many of these barriers can be overcome by the clinician in routine practice.