Objectives: This study analyzed stages of adoption of gastric cancer screening and explored relationshipswith the processes of change, pros, cons, and self-efficacy in an effort to assess the barriers to and facilitators ofregular gastric cancer screening. Methods: The study sample consisted of 650 participants who were at least 40years old, had no history of cancer, and resided in two urban areas in Korea. Stages of adoption, processes ofchanges, pros and cons of screening, and self-efficacy were recorded from January 12 to February 16, 2009. Datawere assessed by analysis of variance and logistic regression. Results: The stage of adoption was determined for650 respondents, of whom 52 were in the precontemplation stage (8.0%), 209 in the contemplation stage (32.0%),52 in the action stage (8.0%), and 337 in the maintenance stage (51.8%). Those who underwent regular gastriccancer screening were more committed, more willing to participate in the healthcare system, perceived fewercons of screening, reported a greater self-efficacy, and perceived gastric cancer risk as moderate. Conclusions:Our findings should be helpful for the development of intervention strategies designed to improve recognitionof the importance of cancer screening and encourage Koreans to undergo regular screening for gastric cancer.