Helgestad Anne Dorte Lerche, Karlsen Alexandra Winkler, Njor Sisse, Andersen Berit, Larsen Mette Bach
University Research Clinic for Cancer Screening, Department of Public Health Programmes, Randers Regional Hospital, Skovlyvej 15, 8630 Randers, NO, Denmark.
Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Blvd. 82, 8200 Aarhus, N, Denmark.
Prev Med Rep. 2025 Mar 14;53:103022. doi: 10.1016/j.pmedr.2025.103022. eCollection 2025 May.
Health literacy may be related to non-participation in cancer screening, but there is limited understanding of its association with participation across all cancer screening programmes. This study aims to explore the associations between health literacy and advancing in participation in cancer screening programmes.
We conducted a cross-sectional study involving women aged 53-65 years residing in Denmark on 31 March 2018. Data utilised was from population registries and self-reported health literacy (HLS-EU-Q16) collected autumn 2017. Uni- and multivariate ordinal logistic regression models were employed to assess associations between health literacy levels and the likelihood of increased attendance in cancer screening programmes. Results were presented as odds ratios (ORs) with 95 % confidence intervals (CIs).
Of the women included, 2668 (69.8 %) responded to the health literacy questionnaire. Among these, 53.3 % demonstrated adequate health literacy, 34.4 % had problematic, and 12.3 % inadequate. In total, 71.2 % attended three screening programmes, 20.1 % attended two, 6.2 % attended one, and 2.5 % attended none.There were no differences in the ORs for advancing in screening attendance when comparing problematic (OR = 1.18, 95 % CI: 0.97-1.42) or inadequate (OR = 0.96, 95 % CI: 0.74-1.26) health literacy levels with an adequate level.
Our study suggests that health literacy does not significantly influence cancer screening participation among the studied population in Denmark. Therefore, interventions aimed at increasing screening participation in this group should not only target health literacy but also focus on other aspects of non-participation.
健康素养可能与不参与癌症筛查有关，但对于其与所有癌症筛查项目参与情况之间的关联，人们的了解有限。本研究旨在探讨健康素养与癌症筛查项目参与进展之间的关联。
我们于2018年3月31日对居住在丹麦的53至65岁女性进行了一项横断面研究。所使用的数据来自人口登记处以及2017年秋季收集的自我报告健康素养（HLS-EU-Q16）。采用单变量和多变量有序逻辑回归模型来评估健康素养水平与癌症筛查项目参与度增加可能性之间的关联。结果以优势比（OR）及95%置信区间（CI）呈现。
在所纳入的女性中，2668名（69.8%）对健康素养问卷做出了回应。其中，53.3%表现出具备足够的健康素养，34.4%存在问题，12.3%不足。总体而言，71.2%的人参加了三项筛查项目，20.1%参加了两项，6.2%参加了一项，2.5%一项都没参加。将存在问题（OR = 1.18，95% CI：0.97 - 1.42）或不足（OR = 0.96，95% CI：0.74 - 1.26）的健康素养水平与足够水平相比较时，在筛查参与进展的OR方面没有差异。
我们的研究表明，健康素养对丹麦研究人群中的癌症筛查参与没有显著影响。因此，旨在提高该群体筛查参与度的干预措施不应仅针对健康素养，还应关注不参与的其他方面。
