Limited cancer health literacy rates and factors associated with cancer health literacy in persons with or without a cancer diagnosis

Background Health literacy is a key factor for health communication efforts. This is especially true for preventing noncommunicable chronic diseases such as cancer. Specifically, limited cancer health literacy (LCHL) is a risk factor for not engaging in disease prevention and treatment.Aims This study aimed to obtain model-based estimates of LCHL rates and explore rate differences in sociodemographic characteristics.Methods Data from cancer patients (N = 1,306) and those without cancer (N = 512) collected from the U.S. were used to estimate crude and adjusted LCHL rates using latent class analysis. Measurement invariance tests were conducted between demographic groups to test the assumption that LCHL has the same meaning across subpopulations.Results Scalar invariance model was supported in all comparisons. Among cancer patients, approximately 10-fold crude rate differences in LCHL were found between Blacks (50%) and Whites (5%), patients with education level up to high school (54%) and above high school (6%), as well as patients earning less than $40K (50%) and $40K or above (4%) annually. A parallel 10-fold difference between race, education, and income groups was also found among persons without cancer but the LCHL rates were somewhat higher among persons without cancer than those with cancer across all groups.Discussion Adjusted rate differences between groups were quite similar. LCHL is highly prevalent among Blacks, under-educated, and low-income persons with and without a diagnosis of cancer. Race, educational attainment, and income are the primary drivers of disparities in cancer health literacy. Our findings help to inform targeted health communication efforts to minimize adverse health and financial consequences of LCHL.