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Health Literacy In The Context Of Cancer Awareness and Treatment

Following last week’s interview discussing health literacy in infectious diseases research, this week’s instalment for Health Literacy Month highlights how important health literacy is in the context of cancer awareness and treatment.

Cancer is common, with 1 in 2 people developing some form of cancer in their lifetime, and it is a distressing diagnosis to receive. Health literacy directly impacts many aspects of cancer. This includes improving the chances of staying cancer-free by making conscious lifestyle decisions, detecting the disease early by encouraging regular screening, and improving quality of life by empowering patients to manage their illness more effectively. Nearly one third of adults needing palliative care have cancer (34%); spending adequate amounts of time with these patients is paramount to addressing gaps in their knowledge, and actively involving them in decision-making.

The PLOS ONE articles highlighted in this blog explore how health literacy impacts many aspects of cancer care and prevention, including lifestyle choices, screening, disease management, and shared decision-making.

Empowering young people to positively affect their future


Woods-Townsend and colleagues attempted to increase health literacy in the next generation, engaging nearly 3000 13–14-year-old UK secondary school pupils in a trial focused on “Me, my health and my children’s health”. At 12 months after the LifeLab educational intervention, the standardized total theoretical health literacy score of the students increased, and they moved towards a more critical judgement of their own health behavior. These findings show how important it is to improve health literacy in young people. This is particularly important, as we know that a healthy lifestyle can reduce the risk of developing non-communicable diseases, including cancer.

Better health literacy leads to increased uptake of cancer screening

Image by stefamerpik on Freepik

Cancer screening is a key approach to reducing cancer mortality. The number of cancer patients in Nepal has increased significantly, hand-in-hand with changing lifestyles and increased exposure to risk factors. In this cross-sectional study, Koirala and colleagues investigate cancer literacy rates in 180 Nepalese adults aged 18 years and above, using the Cancer Health Literacy Test. The authors found that cancer screening rates and cancer literacy scores were low in the general population, and that cancer literacy, age, gender and family support were significantly associated with cancer screening behavior.

Understanding cancer improves aspects of disease management

Mohamed_hassan, Pixabay

Understanding a cancer diagnosis and treatment options is crucial, so patients can make informed decisions regarding their health. In this mixed studies systematic review, Holden and colleagues investigate how health literacy relates to outcomes in patients. For example, lower health literacy was associated with higher and more variable estimates of risk relating to breast cancer recurrence and a greater unmet information need. The authors put special emphasis on understanding the influence of health literacy on access to medical care, revealing the important part played by healthcare professionals and their ability to explain this complex disease and treatment options. A lack of knowledge can lead to patients consenting to treatment without fully comprehending potential risks and benefits. This can also increase their fear, which in turn acts as a barrier to obtaining more information.

Time to communicate improves shared decision-making

Parentingupstream, Pixabay

Shared decision-making is challenging in patients with limited health literacy. In their qualitative study, Roodbeen and colleagues investigate the strategies taken by healthcare providers regarding communication and shared decision-making in hospital-based palliative care, and the barriers they face. They highlight how important it is to have enough time to communicate with patients, and that more awareness is necessary to recognize low health literacy. Look out for our interview next week with author Prof. Dr. Sandra van Dulmen, who will be telling us more about this study and her research in patient-centered medicine.

Cover image by Freepik


A cluster-randomised controlled trial of the LifeLab education intervention to improve health literacy in adolescents; Kathryn Woods-Townsen, Polly Hardy-Johnson, Lisa Bagust, Mary Barker, Hannah Davey, Janice Griffiths,  Marcus Grace, Wendy Lawrence, Donna Lovelock, Mark Hanson, Keith M. Godfrey, Hazel Inskip; Published: May 5, 2021

Role of cancer literacy in cancer screening behaviour among adults of Kaski district, Nepal; Reecha Koirala, Nisha Gurung, Sarita Dhakal, Sulata Karki; Published: July 13, 2021

The role of health literacy in cancer care: A mixed studies systematic review; Chloe E. Holden, Sally Wheelwright, Amélie Harle, Richard Wagland; Published: November 12, 2021

Communication and shared decision-making with patients with limited health literacy; helpful strategies, barriers and suggestions for improvement reported by hospital-based palliative care providers; Ruud Roodbeen, Astrid Vreke, Gudule Boland, Jany Rademakers, Maria van den Muijsenbergh, Janneke Noordman, Sandra van Dulmen; Published: June 19, 2020

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