Al Hussein Al Awamlh Bashir, Moses Kelvin A, Whitman Julia, Stewart Thomas, Kripalani Sunil, Idrees Kamran
Department of Urology, Weill Cornell Medicine/New York-Presbyterian, New York, New York, USA.
Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Cancer. 2025 Mar 15;131(6):e35794. doi: 10.1002/cncr.35794.
The association between health literacy and all-cause mortality among cancer patients remains unclear.
This is a retrospective cohort study of 9603 patients diagnosed with prostate, lung, breast, renal, colorectal, brain, head and neck, bladder, pancreatic, liver, sarcoma, and gastric cancers who were screened for health literacy between 2008 and 2018, using the Brief Health Literacy Screen (BHLS). Higher scores (range, 3-15) indicate higher health literacy. The association between all-cause mortality and health literacy was estimated using multivariable Cox proportional hazards models.
A total of 8608 (89%) patients were non-Hispanic White. The median follow-up was 3.1 years. Patients with a BHLS score of 15 had a median survival improvement of 9.4 months (95% confidence interval [CI], 6.0-13.2 months) compared to those with a score of 9. Lower BHLS scores (9 vs. 15) were associated with higher mortality in stages II (adjusted hazard ratio [aHR], 2.6 [95% CI, 1.5-5.1]) and III (aHR 2.9 [95% CI, 1.4-6.0]) prostate cancer; stages I (aHR 1.7 [95% CI, 1.1-2.5]) and IV (aHR, 1.6 [95% CI, 1.2-2.1]) lung cancer; stage I colorectal cancer (aHR, 2.2 [95% CI, 1.3-4.7]); stage I renal cancer (aHR, 1.8 [95% CI, 1.1-3.4]); stages I (aHR, 2.6 [95% CI, 1.3-7.1]) and IV (aHR, 1.7 [95% CI, 1.2-2.7]) head and neck cancer; stage II bladder cancer (aHR, 1.6 [95% CI, 1.0-2.8]); stage I liver cancer (aHR, 4.1 [95% CI, 1.9-9.3]); and all stages of breast cancer.
Lower health literacy was associated with higher all-cause mortality among patients with 12 different types of cancer, varying by cancer type and stage.
癌症患者的健康素养与全因死亡率之间的关联尚不清楚。
这是一项回顾性队列研究，研究对象为9603例被诊断患有前列腺癌、肺癌、乳腺癌、肾癌、结直肠癌、脑癌、头颈癌、膀胱癌、胰腺癌、肝癌、肉瘤和胃癌的患者，他们在2008年至2018年期间使用简易健康素养筛查工具（BHLS）进行了健康素养筛查。得分越高（范围为3 - 15分）表明健康素养越高。使用多变量Cox比例风险模型估计全因死亡率与健康素养之间的关联。
共有8608名（89%）患者为非西班牙裔白人。中位随访时间为3.1年。与BHLS得分为9分的患者相比，得分为15分的患者中位生存期延长了9.4个月（95%置信区间[CI]，6.0 - 13.2个月）。较低的BHLS得分（9分与15分相比）与II期（调整后风险比[aHR]，2.6 [95% CI，1.5 - 5.1]）和III期（aHR 2.9 [95% CI，1.4 - 6.0]）前列腺癌、I期（aHR 1.7 [95% CI，1.1 - 2.5]）和IV期（aHR，1.6 [95% CI，1.2 - 2.1]）肺癌、I期结直肠癌（aHR，2.2 [95% CI，1.3 - 4.7]）、I期肾癌（aHR，1.8 [95% CI，1.1 - 3.4]）、I期（aHR，2.6 [95% CI，1.3 - 7.1]）和IV期（aHR，1.7 [95% CI，1.2 - 2.7]）头颈癌、II期膀胱癌（aHR，1.6 [95% CI，1.0 - 2.8]）、I期肝癌（aHR，4.1 [95% CI，1.9 - 9.3]）以及所有分期的乳腺癌的较高死亡率相关。
较低的健康素养与12种不同类型癌症患者的较高全因死亡率相关，且因癌症类型和分期而异。
