Abstract
Low health literacy has been associated with poor cancer screening uptake, difficulty in making treatment choices and reduced quality of life following a cancer diagnosis, yet it is unclear whether and how health literacy influences the pathway to diagnosis for patients with cancer symptoms. This systematic review aimed to evaluate the influence of health literacy on the timely diagnosis of symptomatic cancer. Literature was searched between January 1990 and May 2017 using MEDLINE, Embase, Scopus, ASSIA, CINAHL and PsycINFO. Only three papers met the inclusion criteria. These reported two qualitative studies and one quantitative, with adult patients diagnosed with gastrointestinal (colon, rectum and pancreas), cervical and breast cancer. The definition and assessment of health literacy varied between the studies, as did the descriptions of the pathway to diagnosis. Due to the methodological weaknesses identified, the conclusions are limited; however, the studies did highlight important considerations in the definition and measurement of health literacy. Further research is required that clearly defines health literacy and follows the principles of the Aarhus Statement to assess the influence of health literacy on the pathway to cancer diagnosis. The protocol for this review was registered with PROSPERO (CRD42016048917).
Highlights
Public Health England (2015) has described health literacy as the “bridge between people and health settings,” reflecting how patients access, understand, evaluate and use healthcare information and nav‐ igate the services available to them
In searching a wide range of databases with a broad search strategy, we are confident that we identified all articles that aimed to explore health literacy on the time to diagnosis of cancer
Due to the few studies identified from the systematic search, and their methodological weakness and relatively poor quality, it was not possible to fully evaluate the influence of health literacy on the timely diagnosis of symptomatic cancer
Summary
Public Health England (2015) has described health literacy as the “bridge between people and health settings,” reflecting how patients access, understand, evaluate and use healthcare information and nav‐ igate the services available to them. Difficulties in communication may act as a barrier for accessing support services, possibly contributing to worse mental health outcomes as seen for low health literate men newly diagnosed with prostate cancer (Song et al, 2012) While this suggests that low health literacy may affect cancer screening and treatment pathways, it remains unclear how health literacy may influence the timely diag‐ nosis of cancer in symptomatic patients. Key findings have identified a significant variation in the time to diagnosis across cancers, from symptom onset to first presentation in primary care, sub‐ sequent referral and cancer diagnosis (Din et al, 2015; Lyratzopoulos et al, 2015) Frameworks such as the Categorisation of Delay model (Olesen, Hansen, & Vedsted, 2009) and the Model of Pathways to Treatment (Scott, Walter, Webster, Sutton, & Emery, 2013; Walter, Webster, Scott, & Emery, 2012) are useful for describing the intervals along the pathway to diagnosis, while the Aarhus Statement suggested ways to improve the design and reporting of studies (Weller et al, 2012). We aimed to evaluate the impact of health literacy on the timely diagnosis of symptomatic cancer
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
