title: Health literacy and fear of cancer progression in elderly women newly diagnosed with breast cancer--A longitudinal analysis.
abstract: OBJECTIVE
  This study aims to investigate the distribution of health literacy levels and the association of health literacy with fear of cancer progression (FoP) over the course of cancer treatment in a sample of elderly women newly diagnosed with breast cancer.
  
  
  METHODS
  The analyses are part of a prospective, multicenter cohort-study (PIAT) that took place in Germany between 2013 and 2014. Elderly women (aged 65 years and older) newly diagnosed with breast cancer completed validated measures of health literacy and FoP directly after the breast cancer surgery and 40 weeks later. Multivariate random-effects regression analysis for longitudinal data was applied to estimate the association of health literacy with FoP considering socio-demographic, clinical and psychosocial characteristics of the patients.
  
  
  RESULTS
  About half of the elderly breast cancer patients in our sample were classified as having limited health literacy (inadequate and problematic levels). Inadequate and problematic health literacy were significantly associated with higher levels of FoP in the elderly breast cancer patients.
  
  
  CONCLUSIONS
  Limited health literacy is an independent risk factor for increased FoP.
  
  
  CONCLUSIONS
  Enhancing health literacy could contribute to reducing patients' cancer-related fears.
authors.affiliation: Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, Cologne, Germany. Electronic address: sarah.halbach@uk-koeln.de.
authors.forename: Sarah Maria
authors.initials: SM
authors.lastname: Halbach
authors.affiliation: Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, Cologne, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Enders
authors.affiliation: German Cancer Society e.V. (DKG), Berlin, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Kowalski
authors.affiliation: Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, Cologne, Germany.
authors.forename: Timo-Kolja
authors.initials: TK
authors.lastname: Pförtner
authors.affiliation: Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, Cologne, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Pfaff
authors.affiliation: German Cancer Society e.V. (DKG), Berlin, Germany.
authors.forename: Simone
authors.initials: S
authors.lastname: Wesselmann
authors.affiliation: Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, Cologne, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Ernstmann
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000523:psychology*; D054626:Consumer Health Information; D018450:Disease Progression; D005239:Fear / Q000523:psychology*; D005260:Female; D005858:Germany; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011446:Prospective Studies
keywords: Anxiety; Breast cancer; Elderly; Fear of cancer progression; Geriatric oncology; Health literacy; Psycho-oncology