Improving cancer literacy in Europe to save time, costs and lives (Guest blog)
Cancer is the most important cause of death and illness in Europe after cardiovascular diseases. With 3.7 million new patients per year, Europe pursues around 25% of the global total of cancer cases. However, cancer is in many cases avoidable, and early detection increases the chance of cure substantially. Thus, health literacy will be an important factor to improve the cancer journey through advancement of people’s capacity and the services of healthcare providers. Empowering the cancer patient is key for a timely and more positive patient experience.
Health literacy entails the knowledge, motivation, and competencies to access, appraise, understand, and apply information for making decisions concerning healthcare, disease prevention and health promotion, and to maintain and improve quality of life during the life course with support from relevant organizational stakeholders. In the context of cancer literacy, it refers to the knowledge and skills needed to find, understand, evaluate and use the information and advice the health system has to offer with regard to prevention, diagnosing, and treating cancer. Regrettably, low cancer literacy has been shown to hinder patients at every stage of the cancer journey. Thus, improving cancer literacy in Europe can help save time, costs, and lives.
The investment in cancer literacy saves time. Compared to many other diagnoses and diseases, there are many time-critical decisions to be made by both the patient and provider, since early screening, diagnosis, or starting treatment have an impact on chances to survive. Early detection of cancer greatly increases the chances of survival. Cancer treatments can be complex and involve multiple physicians, tests, treatments, and the need to manage potential side effects. The possibility of early detection using genetic testing, and the difficulties associated with understanding both the test terms and test results, make decisions complex. Improved personal cancer literacy combined with health literate organizations and systems can, therefore, improve the quality of care and health outcomes among patients with cancer.
The investment in cancer literacy saves costs. Early detection is essential, however; low health literacy is associated with avoidance of doctor visits and confusion about screenings. People with low health literacy are significantly less likely to report having heard of a colonoscopy, mammography, or prostate-specific antigen test or to correctly identify the cancer being screened for with each test. In addition to influencing screening and treatment decisions, low health literacy can negatively affect the use of end-of-life and palliative care services. Generally, low health literacy is a major source of economic inefficiency in health systems. Improved cancer literacy of patients and communication skills of health professionals involved in cancer-related services will support a more cohesive and sustainable cancer journey that pays off in return of economic investments.
The investment in cancer literacy saves lives. Almost one third or more are thought to have limited health literacy according to European research. With lower levels of health literacy people are at risk of worse health. Subgroups particularly vulnerable to limited health literacy include older adults and people with low educational attainment or low socioeconomic status/financial deprivation. Health literacy as a social determinant of health can be modified to increase health and wellbeing. Making universal precautions will increase levels of all; while specific attention to increase cancer literacy among people at risk, will help to narrow the gap and diminish inequalities associated to cancer care.
Amplifying the impact requires political action. Interestingly, a ripple effect has been seen in countries with health literacy on national policy agendas. Countries like Austria, Germany, Norway, Portugal, and Scotland that have adopted health literacy policy goals and strategies; also indicate health literacy as an important action area in national cancer control plans. Importantly, the European Commission can pave the way by including cancer literacy in Europe’s Beating Cancer Plan to enhance research, policy, and practice European wide.
Improved cancer literacy combined with the development of health literate organizations and systems can potentially improve patient care along the whole range of the continuum of care, while potentially reducing the cost of unnecessary and inappropriate care. A European wide effort on cancer literacy will support the ultimate goal of better outcomes for all cancer patients.