Health Literacy Levels in Oncology Patients

BACKGROUND: Nearly half of patients diagnosed with cancer face barriers rooted in limited health literacy (HL). In oncology, where decisions are complex and consequences high, these barriers translate into poor adherence, preventable complications, and avoidable suffering. OBJECTIVE: To determine HL prevalence among adults with solid malignant neoplasms at a university cancer center in Mexico and identify sociodemographic factors associated with adequate HL. METHODS: This observational, cross-sectional study (N = 195) was conducted at a specialized university cancer center in northeastern Mexico. Adults with confirmed malignant neoplasm diagnoses receiving active treatment or posttreatment follow-up were enrolled consecutively. HL was assessed using the HLS-EU-Q12, a validated 12-item Spanish-language instrument (4-point Likert scale; total score 12-48), analyzed using adjusted binary logistic regression. RESULTS: The mean HL score was 33.1 points (SD 4.4). Adequate HL was found in 57.9%; 42.1% showed inadequate HL. High school or university education was the only sociodemographic factor independently associated with adequate HL (odds ratio: 3.51; 95% CI, 1.60-7.73; P = .002). Time since diagnosis was not associated with HL (P = .928). CONCLUSIONS: Nearly half of patients diagnosed with cancer face information vulnerability. Because HL does not improve passively over time, proactive communication-tailored, caregiver-inclusive, and initiated at diagnosis-is a clinical and ethical imperative. IMPLICATIONS FOR ONCOLOGY NURSING PRACTICE: Limited HL affects nearly half of patients regardless of time since diagnosis. Oncology nurses, with the most sustained patient contact, are positioned to identify vulnerable patients and lead plain-language, caregiver-inclusive communication. Routine HL screening should be integrated into oncology nursing practice as a standard of equitable care.