OBJECTIVE: The purpose of this study was to describe the rate of Papanicolaou (Pap) smear test use among women participating in a breast cancer screening program in Greece and to determine related factors. METHODS: Between March 2004 and July 2009, 9682 women aged between 40 and 69 years were recruited into the program. Baseline sociodemographic and lifestyle characteristics were recorded, together with familial medical history and the last time they had undergone a Pap test. RESULTS: Almost 7% of the participants had never had a Pap test, and 28.8% had not had one within the last 3 years. Factors that were found to be independently associated with never receiving a Pap test or with not having one within the last 3 years included age, educational status, marital status, area of residence, health insurance, nationality, oral contraceptive use, cancer family history, body mass index (BMI), and stability of menstrual cycle. CONCLUSIONS: The rate of Pap test use is high among women who reside in Greece, although it is possible that this rate is a little overestimated. Specific programs should be developed and implemented that aim to increase awareness of the benefits of regular cervical cancer screening among specific subgroups of women.