Oldach Benjamin R, Katz Mira L
Comprehensive Cancer Center, The Ohio State University, Columbus, USA.
Comprehensive Cancer Center, The Ohio State University, Columbus, USA; Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, USA.
Patient Educ Couns. 2014 Feb;94(2):149-57. doi: 10.1016/j.pec.2013.10.001. Epub 2013 Oct 14.
To evaluate published evidence about health literacy and cancer screening.
Seven databases were searched for English language articles measuring health literacy and cancer screening published in 1990-2011. Articles meeting inclusion criteria were independently reviewed by two investigators using a standardized data abstraction form. Abstracts (n=932) were reviewed and full text retrieved for 83 articles. Ten articles with 14 comparisons of health literacy and cancer screening according to recommended medical guidelines were included in the analysis.
Most articles measured health literacy using the S-TOFHLA instrument and documented cancer screening by self-report. There is a trend for an association of inadequate health literacy and lower cancer screening rates, however, the evidence is mixed and limited by study design and measurement issues.
A patient's health literacy may be a contributing factor to being within recommended cancer screening guidelines.
Future research should: be conducted using validated health literacy instruments; describe the population included in the study; document cancer screening test completion according to recommended guidelines; verify the completion of cancer screening tests by medical record review; adjust for confounding factors; and report effect size of the association of health literacy and cancer screening.
评估已发表的关于健康素养与癌症筛查的证据。
检索了七个数据库，查找1990年至2011年期间发表的测量健康素养与癌症筛查的英文文章。符合纳入标准的文章由两名研究人员使用标准化数据提取表进行独立评审。对932篇摘要进行了评审，并检索了83篇文章的全文。分析纳入了10篇文章，其中有14项根据推荐的医学指南对健康素养与癌症筛查进行的比较。
大多数文章使用S-TOFHLA工具测量健康素养，并通过自我报告记录癌症筛查情况。健康素养不足与较低的癌症筛查率之间存在关联趋势，然而，证据参差不齐，且受研究设计和测量问题的限制。
患者的健康素养可能是符合推荐癌症筛查指南的一个促成因素。
未来的研究应：使用经过验证的健康素养工具进行；描述研究中纳入的人群；根据推荐指南记录癌症筛查测试的完成情况；通过病历审查核实癌症筛查测试的完成情况；调整混杂因素；并报告健康素养与癌症筛查关联的效应大小。
