BACKGROUND: Colorectal cancer (CRC) incidence is rising in urban China, and screening participation remains low. Understanding the influence of knowledge and health beliefs on CRC screening behaviors can inform targeted interventions. OBJECTIVE: To identify latent profiles of CRC knowledge and health beliefs among average-risk urban adults in China and examine factors influencing profile membership. METHODS: A cross-sectional study was conducted with 500 urban adults, utilizing validated questionnaires on CRC knowledge and health beliefs. Latent profile analysis identified distinct profiles, and multinomial logistic regression assessed sociodemographic predictors. RESULTS: Three profiles emerged: profile 1, "moderately informed and believing" (48.0%, n = 240)
profile 2, "underinformed and skeptical" (18.8%, n = 94)
and profile 3, "well-informed and strongly believing" (33.2%, n = 166). Unstable employment and low health literacy predicted membership in profile 2, whereas higher social support and proximity to health centers were associated with profile 3. Profile 2 negatively predicted screening behavior (β = -0.516) and intention (β = -0.786), whereas profile 3 showed positive associations (β = 0.541 and β = 0.969, respectively). CONCLUSIONS: These findings highlight distinct CRC knowledge and health belief profiles, suggesting that tailored interventions addressing subgroup-specific gaps and barriers could enhance CRC screening engagement in urban China. IMPLICATIONS FOR PRACTICE: Nurses can efficiently identify at-risk populations through brief assessments of employment status, health literacy, and social support and implement targeted interventions such as patient navigation, simplified health education, and social support enhancement to improve screening uptake.