Evidence map›Paper›PMID 40045673›Full record

ArticleCancer2025

Health literacy and all-cause mortality among cancer patients.

Bashir Al Hussein Al Awamlh, Kelvin A Moses, Julia Whitman, Thomas Stewart, Sunil Kripalani, Kamran Idrees

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Review
  2. Article
  3. Evaluating the role of survivorship care plans in modifying disparities in health status among female cancer survivors in Maryland.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  4. Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Bashir Al Hussein Al AwamlhDepartment of Urology, Weill Cornell Medicine/New York-Presbyterian, New York, New York, USA.ORCID https://orcid.org/0000-0001-8552-4951
Kelvin A MosesDepartment of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0003-3231-2941
Julia WhitmanDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Thomas StewartSchool of Data Science, University of Virginia, Charlottesville, Virginia, USA.ORCID https://orcid.org/0000-0002-5138-0758
Sunil KripalaniDepartment of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Kamran IdreesDepartment of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe association between health literacy and all-cause mortality among cancer patients remains unclear.

methodsThis 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.

resultsA 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.

conclusionsLower health literacy was associated with higher all-cause mortality among patients with 12 different types of cancer, varying by cancer type and stage.

Indexed as

Health LiteracyNeoplasmsAdultAgedAged, 80 and overCause of DeathFemaleHumansMaleMiddle AgedProportional Hazards ModelsRetrospective Studiesbrief health literacy screencancerhealth literacy

Identifiers

PMID40045673
PMCPMC11883198

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.