ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
The role of health literacy in treatment decision-making for patients with early-stage laryngeal cancer: a cross-sectional study.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeHealth literacy (HL) critically affects patients’ understanding of cancer care and shared decision-making, yet its role in treatment preference for early-stage laryngeal squamous cell carcinoma (LSCC) is unclear. This study aims to assess whether HL influences treatment modality selection and to explore its relationship with quality of life (QoL) and sociodemographic factors.
methodsThis cross-sectional study included 104 patients diagnosed with T1–T2N0 glottic LSCC who underwent transoral laser laryngeal microsurgery (TLM) or radiotherapy (RT). Participants completed the European Health Literacy Survey Questionnaire (HLS-EU-Q47), the University of Washington Quality of Life Questionnaire Version 4 (UW-QOL v4), and the Voice Handicap Index-10 (VHI-10) questionnaires. Associations between variables were analyzed using multivariate logistic regression.
resultsAdequate HL was more frequent in the TLM group (51.9%) than in the RT group (25.0%) (p = 0.009). Adequate HL was independently associated with an increased likelihood of choosing TLM (OR = 3.939, 95% CI: 1.611–9.634, p = 0.003), whereas being currently employed was associated with a preference for RT over TLM (OR = 0.374, 95% CI: 0.150–0.930, p = 0.034). Voice and QoL outcomes did not differ significantly between treatment groups; however, adequate HL correlated positively with UW-QOL scores (r = 0.26, p = 0.008).
conclusionHigher HL is associated with TLM preference and improved QoL in early-stage LSCC. Routine HL assessment may enhance informed decision-making and optimize patient-centered cancer care.
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