Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr;36(2):240-252.
doi: 10.1007/s13187-020-01915-x. Epub 2020 Nov 5.

Health Literacy Interventions in Cancer: a Systematic Review

A J Housten  1 , C M Gunn  2 , M K Paasche-Orlow  2 , K M Basen-Engquist  3
Affiliations

Health Literacy Interventions in Cancer: a Systematic Review

A J Housten et al. J Cancer Educ. 2021 Apr.

Abstract

Approximately one-third of adults in the United States (U.S.) have limited health literacy. Those with limited health literacy often have difficultly navigating the health care environment, including navigating care across the cancer continuum (e.g., prevention, screening, diagnosis, treatment). Evidence-based interventions to assist adults with limited health literacy improve health outcomes; however, little is known about health literacy interventions in the context of cancer and their impact on cancer-specific health outcomes. The purpose of this review was to identify and characterize the literature on health literacy interventions across the cancer care continuum. Specifically, our aim was to review the strength of evidence, outcomes assessed, and intervention modalities within the existing literature reporting health literacy interventions in cancer. Our search yielded 1036 records (prevention/screening n = 174; diagnosis/treatment n = 862). Following deduplication and review for inclusion criteria, we analyzed 87 records of intervention studies reporting health literacy outcomes, including 45 pilot studies (prevention/screening n = 24; diagnosis/treatment n = 21) and 42 randomized controlled trials or quasi-experimental trials (prevention/screening n = 31; diagnosis/treatment n = 11). This literature included 36 unique interventions (prevention/screening n = 28; diagnosis/treatment n = 8), mostly in the formative stages of intervention development, with few assessments of evidence-based interventions. These gaps in the literature necessitate further research in the development and implementation of evidence-based health literacy interventions to improve cancer outcomes.

Keywords: Cancer; Health literacy; Neoplasms; Oncology.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest/Competing interests: Authors have no conflicts of interest to report at this time.

Figures

Figure 1.
Figure 1.
Literature search for cancer and health literacy
See this image and copyright information in PMC

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA: A Cancer Journal for Clinicians. 2019;69(1):7–34. - PubMed
    1. Polite BN, Adams-Campbell LL, Brawley OW, et al. Charting the Future of Cancer Health Disparities Research: A Position Statement from the American Association for Cancer Research, the American Cancer Society, the American Society of Clinical Oncology, and the National Cancer Institute. Cancer Research. 2017;77(17):4548. - PubMed
    1. Ward E, Jemal A, Cokkinides V, et al. Cancer Disparities by Race/Ethnicity and Socioeconomic Status. CA: A Cancer Journal for Clinicians. 2004;54(2):78–93. - PubMed
    1. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low Health Literacy and Health Outcomes: An Updated Systematic Review. Annals of Internal Medicine. 2011;155(2):97–107. - PubMed
    1. Institute of Medicine. Health literacy: a prescription to end confusion. Washington DC: National Academies Press; 2004. - PubMed

Publication types