ArticleCHEST pulmonary2026
Association of Health Literacy With Survival in Patients With Lung Cancer.
Article in CHEST pulmonary, 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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Authors and funding
9 authors.
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Abstract
Background: Lung cancer is the leading cause of cancer-related deaths globally, with survival influenced by stage at diagnosis, comorbidities, and sociodemographic factors. Health literacy, which impacts patients' understanding of medical information and decision-making, has not been well studied in lung cancer survival outcomes. Research Question: In a retrospective cohort of patients diagnosed with lung cancer, how is health literacy associated with overall survival and cancer stage at diagnosis? Study Design and Methods: This retrospective cohort study included patients diagnosed with lung cancer between 2010 and 2022 at a single institution. Health literacy was measured using the Brief Health Literacy Screen (BHLS). Patients were divided into low health literacy (BHLS score ≤ 9) and intermediate-high health literacy (BHLS score > 9) groups. Data on demographics, clinical characteristics, and treatment were collected. Logistic regression examined associations between health literacy and patient characteristics. Cox proportional hazard models evaluated the impact of health literacy on survival, adjusting for covariates. Results: The study included 3,828 patients with lung cancer, and 19.1% (n = 730) had low health literacy. Logistic regression indicated that older age, male sex, non-White race/ethnicity, and lower education were associated with low health literacy. Stage IV disease was associated with increased odds of low health literacy by 65% compared with stage I disease (OR, 1.65; Interpretation: Our results show that low health literacy is associated with late-stage diagnosis and reduced overall survival in patients with lung cancer. Interventions addressing limited health literacy for patients with lung cancer could alleviate these disparities.
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