Cancer fatalism (the belief that death is inevitable when cancer is present) may influence cancer screening practices among older African American women. Little is known about cancer fatalism among younger women. Guided by the Patient/Provider/System Model, this descriptive study compares cancer fatalism and cancer knowledge among African American college students (n = 353) and women from primary care centers (n = 361). Their average age was 29 years. Data were collected using the Powe Fatalism Inventory and breast and cervical cancer knowledge scales. Women at health centers had higher cancer fatalism and lower cancer knowledge. Differences in life experiences may help explain these findings.