In view of the efficacy of the pap-smear, particularly little advantage is taken of this early detection test: only 35% of Austrian women (over 20 years of age) go to at least one gynecological-cytological check-up per year. Previously when low participation in the pap-test program was analsyed, mostly socioeconomic and psychosocial factors were taken into consideration, whereas less attention was given to what local preventive and curative services are being offered in this field. Hereby a structural lack of services offered to the target group of older women results in urban areas, because the elderly population primarily takes advantage of curative medical services offered through general practitioners, of whom, however, only 8-27% take smear tests. Regional low participation can also be found in rural areas, due to the lack of preventive behaviour of the rural population regarding prevention. Based on these results, increasing health information through the physician and improving his motivation to take the smear test seem to be a purposeful strategy for increasing participation in the pap-test program.