title: Health literacy and cancer screening: a systematic review.
abstract: OBJECTIVE
  To evaluate published evidence about health literacy and cancer screening.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  A patient's health literacy may be a contributing factor to being within recommended cancer screening guidelines.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Comprehensive Cancer Center, The Ohio State University, Columbus, USA.
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Oldach
authors.affiliation: 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. Electronic address: mira.katz@osumc.edu.
authors.forename: Mira L
authors.initials: ML
authors.lastname: Katz
mesh_terms: D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D008403:Mass Screening; D009369:Neoplasms / Q000517:prevention & control* / Q000523:psychology
keywords: Cancer; Cancer screening; Health literacy