Currently, the incidence of breast cancer remains high. The "Cancer Screening Program in Urban China" program, initiated by the National Health Commission, aims to promote early diagnosis and treatment among high-risk populations. However, survey results indicate that the current status of screening among high-risk women is still suboptimal.

To explore the barriers and facilitators of screening implementation among the high-risk population for breast cancer, and to provide a basis for formulating targeted implementation strategies.

From September to November 2024, six community health service centers and the sole designated screening hospital in Nanjing, Jiangsu Province, were selected as study sites using convenience sampling. Semi-structured interviews were conducted with medical staff involved in screening work and high-risk women for breast cancer, following the principle of maximum variation sampling. Researchers constructed interview outlines based on the five dimensions and 48 constructs of the Consolidated Framework for Implementation Research (CFIR). And the interview data were analyzed using the content analysis method combined with the top-down approach.

A total of 16 high-risk women for breast cancer, 12 medical personnel from community health service centers, and 10 medical personnel from the designated screening hospital were interviewed. At the screening provider level, barriers included long waiting times for examination and report issuance, limited capacity in interpreting risk assessment results, insufficient information transmission to screening demanders, and unmet human resource and time needs of providers. Facilitators included smooth internal collaboration and adequate reflective work. At the screening recipient level, barriers included digital exclusion, limited information accessibility, insufficient capacity, and weak motivation. Facilitators included perceived risk and benefits, and adequate social support.

There are multi-level barriers and facilitators in screening implementation for high-risk populations of breast cancer. Future efforts should focus on developing targeted implementation strategies to promote the smooth conduct of breast cancer screening, while also providing insights for the overall advancement of the "Cancer Screening Program in Urban China" program.