Barriers and facilitators to participation in colorectal cancer screening: perspectives of adults aged 50–69 and healthcare providers in Iran

Colorectal cancer (CRC) is a common yet preventable cancer, but screening participation remains suboptimal. This study explored barriers and facilitators to CRC screening among adults aged 50–69. This qualitative study was conducted using a content analysis approach, guided by the PRECEDE–PROCEED model. Data were collected through semi-structured interviews with 18 individuals from the target population, recruited via maximum variation and extreme case sampling, as well as with six healthcare providers selected through maximum variation sampling. Data were analyzed using Elo and Kyngäs’ directed content analysis method. Barriers to CRC screening included limited knowledge, misconceptions, fear of diagnosis, low trust in provider recommendations, inadequate social support, poor service accessibility, financial constraints, limited awareness of available services, and appointment difficulties. Facilitators included awareness, positive screening beliefs, symptom experience, social support, accessible services, effective communication, and financial assistance.CRC screening participation was influenced by predisposing, reinforcing, and enabling factors, informing strategies to improve screening uptake.