The importance of health literacy on clinical cancer outcomes: a scoping review

Abstract: A scoping review was conducted to summarize what is known about the associations between health literacy and cancer outcomes and to determine which health literacy measures are most commonly used in cancer health literacy research. Five electronic databases (Ovid Medline, Ovid Embase, PsychInfo, EBSCO CINAHL and ERIC) were searched, yielding 3,591 articles. Of those, 146 met inclusion criteria. Associations between health literacy and preventative cancer behaviours were the most widely examined outcome (N=55, 38%). Post treatment behaviours were the least commonly examined outcome (N=5, 3%). While mixed results were prevalent in the literature, inadequate health literacy was often found to be associated with a myriad of unfavorable health outcomes. A large breadth of health literacy tools was additionally used in the evaluation of health literacy, suggesting that existing measures are inadequate or incomplete, and that no existing measure holistically assess the construct. This review provides a detailed account of the associations between health literacy and cancer in the literature. Health literacy impacts cancer patients’ behaviours and health care service use. Future research is required to advance this field, in order to develop best-practices for health literacy evaluation and to produce programs and policies that aim to enhance patient outcomes.