OBJECTIVE To examine the use of mammography and Papanicolaou (Pap) smear among women with diabetes and to identify predictors of adherence to these tests. RESEARCH DESIGN AND METHODS We analyzed data of a nationally representative sample of Spanish women. Diabetes status was self-reported. Screenings were assessed asking whether they had a mammography (> or =40 years) and a Pap smear (18-69 years) within the previous 2 and 3 years, respectively. RESULTS Women with diabetes were less likely to receive mammography (57.9%) or have a Pap smear (61.5%) than women without diabetes (mammography 61.9%, P < 0.05; Pap smear 65.6%, P < 0.05). After adjusting for age, educational level, income, comorbidity, tobacco use, obesity, and physician visits, the corresponding odds ratios remained significant (0.84, 95% CI 0.72-0.97) and (0.82, 95% CI 0.66-0.98). Higher educational level was a positive predictor for both tests among diabetic women. CONCLUSIONS Spanish women with diabetes underuse breast and cervical cancer screening tests.