Background and Objectives: Colorectal cancer is one of the most common types of cancer worldwide, which ranks second in cancer deaths in Iran. This study was conducted with the aim of explaining the effective factors of non-participation in the colorectal cancer screening program in adults based on the health belief model in Iran. 

Materials and Methods: This cross-sectional study was conducted on 683 adults aged 50-70 years (338 women and 345 men) in the health centers of Daran City of Isfahan. The data was collected using a researcher-made questionnaire based on the health belief model in the summer of 1401. SPSS.23 statistical software was used for data analysis, mean, frequency for description, and correlation and Logistic regression tests were used for data analysis.

Results: The mean age of the participants was 57.5 (standard deviation 8.7) and most of them were men (50.5%). The results of the logistic regression analysis showed that the demographic and cognitive variables based on the health belief model were significantly predicted non-participating in the screening of colorectal cancer in health centers (Adj R=0.46, P<0.01). Among the entered demographic variables, family history of colorectal cancer (OR: 7.69; 95% CI: 3.45-17.09) and among the cognitive variables, knowledge (OR=1.61, 95% CI:1.36-1.9) and Perceived barriers (OR=0.88, 95% CI:0.85-0.92) had the highest predictive power in non-participation.

Conclusion: The results of the present study emphasized the low-risk perception and low knowledge of adults who did not participate in the program. Therefore, it is recommended to use community-based programs to raise people's awareness of the perceived risk of colorectal cancer and the possibility of performing a fit test in health service centers. It is also recommended to create strategies to facilitate participation in the program (such as home screening or mailing) in adults.

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