Evidence map›Paper›PMID 40338401›Full record

ArticleJournal of gastrointestinal cancer2025

The Association Between Health Literacy and Colorectal Cancer Screening: Findings Using a Three-Question Health Literacy Measure.

Alfonsus Adrian H Harsono, Rachel Ruiz, Meghna Katta, Hannah Ficarino Sheffer, Marshall Chandler McLeod, Smita Bhatia, Terry Davis, Daniel I Chu, Robert H Hollis

Erratum issuedAbstract read
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In one paragraph

Article in Journal of gastrointestinal cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Alfonsus Adrian H HarsonoDivision of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, 1808 7 Ave S, BDB 561, Birmingham, AL, 35294-0016, USA.
Rachel RuizSchool of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Meghna KattaSchool of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Hannah Ficarino ShefferDivision of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, 1808 7 Ave S, BDB 561, Birmingham, AL, 35294-0016, USA.
Marshall Chandler McLeodDivision of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, 1808 7 Ave S, BDB 561, Birmingham, AL, 35294-0016, USA.
Smita BhatiaDivision of Pediatric Hematology Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
Terry DavisSchool of Medicine, Louisiana State University, Shreveport, LA, USA.
Daniel I ChuDivision of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, 1808 7 Ave S, BDB 561, Birmingham, AL, 35294-0016, USA.
Robert H HollisDivision of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, 1808 7 Ave S, BDB 561, Birmingham, AL, 35294-0016, USA. rhhollis@uabmc.edu.ORCID http://orcid.org/0000-0002-6761-9890

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeHealth literacy (HL) can impact health behaviors including colorectal cancer (CRC) screening. Prior findings using extensive measures of HL suggested that low HL is associated with lower CRC screening rates. We hypothesized that low HL, when measured using a clinically applicable three-question measure, would also be associated with low CRC screening rates.

methodsData collected from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) was utilized from 17 states that included a three-question HL measure. Participants ages 50-75 were included. The HL scores were categorized as adequate, marginal, or limited HL. The primary outcome was United States Preventative Services Task Force (USPSTF) recommendation-concordant CRC screening. The relationship between HL and CRC screening was examined using multivariable logistic regression.

resultsAmong 38,044 participants who met inclusion criteria, 47.2% (n = 17,950), 49.9% (n = 18,989), and 2.9% (n = 1105) had adequate, marginal, and limited HL, respectively. Lower HL levels were associated with lower adherence to USPSTF CRC screening recommendations: 73.3% for adequate, 68.0% for marginal, and 48.9% for limited HL (p < 0.01). Respondents with limited HL were 45% less likely to undergo CRC screening (OR = 0.55; 95%CI: 0.48-0.63). A significant interaction (p < 0.01) between health literacy and sex was identified. CRC screening difference among HL levels was more pronounced for male (OR = 0.48; 95% CI: 0.40-0.79) than female respondents (OR = 0.63; 95% CI: 0.52-0.76).

conclusionLimited health literacy is associated with significantly lower rates of appropriate CRC screening, particularly for males. This three-question HL measure provides a clinically applicable tool to identify people at risk for lack of CRC screening.

Indexed as

Colorectal NeoplasmsEarly Detection of CancerHealth LiteracyAgedBehavioral Risk Factor Surveillance SystemFemaleHumansMaleMass ScreeningMiddle AgedSurveys and QuestionnairesUnited StatesColorectal cancer screeningHealth disparitiesHealth literacySocial determinants of health

Identifiers

PMID40338401

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.