THE RELATIONSHIP CONTEXT AND PATIENT ACCEPTANCE OF RISK-BASED SCREENINGPace' s personal experience in talking with women in his 20-year continuity practice 3 gives him a different perspective than was found in the study by Smith et al. 4 Smith and colleagues found great reluctance to engage in risk-based cervical cancer screening. Women' s stories about their need for self-advocacy seem to be at odds with Dr. Pace' s experience of a high level of patient acceptance of longer screening intervals. How does a trusting relationship with a clinician affect the patient' s personal experience that seems so important in acceptance of risk-based screening? How do the health care system context and trust affect women' s perception of risk-based screening?Harper et al 5 quote recent data showing the benefi t of longer intervals between cervical cancer screenings. They present their own data showing that among women' s ranking of 22 reasons for an annual examination, having a Pap smear ranked number 8-lower than 5 reasons that relate to the clinician-patient relationship. They raise the provocative hypothesis that "interval screening may be limited not by the frequency of the woman' s visit to her provider, but by the physician' s ability to change his/her screening behaviors.