This study explored the socio-cultural dimensions of immigrant and US-born Filipina women’s orientation toward cancer prevention. In-depth individual interviews were conducted in English or Tagalog with 24 women aged 50–65 years who self-identified as Filipina and resided in the San Francisco Bay Area. The women were recruited from community basedagencies using a direct approach, referral, and snowball sampling. The interviews included questions about lay notions of fate and spirituality and how they infuse Filipina women’s health-seeking behaviour and, in turn, their colorectal cancer (CRC) screening practices. The findings showed that although the women recognised the importance of CRC Screening, they did not assign it high priority because they perceived themselves to be at low risk and they had complex notions of health maintenance which highlighted competing physical and emotional health concerns. A total of 22 women reported having heard of an endoscopic procedure, but only nine reported that they had undergone such a procedure. The women attributed their low perceived risk of CRC to a lack of family history of cancer, the ability to cleanse one’s system, and maintaining a well-balanced lifestyle. Their narratives suggested a world view in which fate and personal responsibility coexist seamlessly, physicians were considered to have a valued role as expert advisers, and there was an emphasis on balance and stress reduction. This world view encourages reventive measures when these are needed, but also allows for their deferral. These older Filipina women’s narratives suggested that they had a holistic health orientation that valued maintenance of both emotional and physical health, and that their behaviour was embedded in a complex socio-cultural milieu. Effective interventions to promote CRC screening among Filipinas must be based on understandings of and integration within this context while simultaneously promoting the preventive benefits of CRC screening procedures.