{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T01:59:14Z","timestamp":1792634354668,"version":"4.5.0"},"reference-count":51,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,3,15]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The association between health literacy and all\u2010cause mortality among cancer patients remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective cohort study of 9603 patients diagnosed with prostate, lung, breast, renal, colorectal, brain, head and neck, bladder, pancreatic, liver, sarcoma, and gastric cancers who were screened for health literacy between 2008 and 2018, using the Brief Health Literacy Screen (BHLS). Higher scores (range, 3\u201315) indicate higher health literacy. The association between all\u2010cause mortality and health literacy was estimated using multivariable Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 8608 (89%) patients were non\u2010Hispanic White. The median follow\u2010up was 3.1 years. Patients with a BHLS score of 15 had a median survival improvement of 9.4 months (95% confidence interval [CI], 6.0\u201313.2 months) compared to those with a score of 9. Lower BHLS scores (9 vs. 15) were associated with higher mortality in stages II (adjusted hazard ratio [aHR], 2.6 [95% CI, 1.5\u20135.1]) and III (aHR 2.9 [95% CI, 1.4\u20106.0]) prostate cancer; stages I (aHR 1.7 [95% CI, 1.1\u20132.5]) and IV (aHR, 1.6 [95% CI, 1.2\u20132.1]) lung cancer; stage I colorectal cancer (aHR, 2.2 [95% CI, 1.3\u20134.7]); stage I renal cancer (aHR, 1.8 [95% CI, 1.1\u20133.4]); stages I (aHR, 2.6 [95% CI, 1.3\u20137.1]) and IV (aHR, 1.7 [95% CI, 1.2\u20132.7]) head and neck cancer; stage II bladder cancer (aHR, 1.6 [95% CI, 1.0\u20132.8]); stage I liver cancer (aHR, 4.1 [95% CI, 1.9\u20139.3]); and all stages of breast cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Lower health literacy was associated with higher all\u2010cause mortality among patients with 12 different types of cancer, varying by cancer type and stage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.35794","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T18:57:42Z","timestamp":1741719462000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Health literacy and all\u2010cause mortality among cancer patients"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8552-4951","authenticated-orcid":false,"given":"Bashir","family":"Al Hussein Al Awamlh","sequence":"first","affiliation":[{"name":"Department of Urology Weill Cornell Medicine\/New York\u2010Presbyterian  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3231-2941","authenticated-orcid":false,"given":"Kelvin A.","family":"Moses","sequence":"additional","affiliation":[{"name":"Department of Urology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Whitman","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5138-0758","authenticated-orcid":false,"given":"Thomas","family":"Stewart","sequence":"additional","affiliation":[{"name":"School of Data Science University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Kripalani","sequence":"additional","affiliation":[{"name":"Department of Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamran","family":"Idrees","sequence":"additional","affiliation":[{"name":"Department of Surgery Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/phh.0000000000001324"},{"key":"e_1_2_9_3_1","volume-title":"The health literacy of America's adults: Results from the 2003 National Assessment of Adult Literacy","author":"Kutner M","year":"2006"},{"key":"e_1_2_9_4_1","unstructured":"VernonJA TrujilloA RosenbaumSJ DeBuonoB.Low health literacy: implications for national health policy.2007; 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