BACKGROUND: Recent studies suggest that American Indian and Alaska Native women have important barriers to cancer screening and underuse cancer screening tests. METHODS: We examined the breast and cervical cancer screening practices of 4,961 American Indian and Alaska Native women in 47 states from 1992 through 1997 by using data from the Behavioral Risk Factor Surveillance System. RESULTS: About 65.1% [95% confidence interval (CI) 60.2 to 69.9%] of women in this sample aged 50 years or older had received a mammogram in the past 2 years. About 82.6% (95% CI 80.1 to 85.2%) of women aged 18 years or older who had not undergone a hysterectomy had received a Papanicolaou test in the past 3 years. Older women and those with less education were less likely to be screened. Women who had seen a physician in the past year were much more likely to have been screened. CONCLUSIONS: These results underscore the need for continued efforts to ensure that American Indian and Alaska Native women who are elderly or medically underserved have access to cancer screening services.