The use of Pap smears and mammograms in the Native American population is not well documented and the validity of women's self-reports is unknown. The purpose of this study was to examine the agreement between women's self-reports of their Pap smear and mammogram histories with their medical records in one Native American tribe. Two hundred fifty-one women between the ages of 35 and 65 answered questions regarding their Pap smear and mammogram histories. These women then underwent an education program and one year later they again answered questions about their Pap smear and mammogram histories. Two hundred four of the original 251 women completed the education program and the second questionnaire. On the first questionnaire, 51.0% of women's claims to have received a Pap smear within the past 12 months were verified by the record audit and 69.2% of claims of receiving a mammogram within the past 12 months were verified. On the second questionnaire, 46.7% of women who said they had received a Pap smear within the past 12 months had their claims verified by their records, and 45.2% of women's claims of receiving a mammogram within the past 12 months were verified. These results suggest that patient recall alone should not be used to determine date of last procedure.