A scoping review was conducted to summarize what is known about the associations between health literacy and cancer outcomes and to determine which health literacy measures are most commonly used in cancer health literacy research. Five electronic databases (Ovid Medline, Ovid Embase, PsychInfo, EBSCO CINAHL and ERIC) were searched, yielding 3,591 articles. Of those, 146 met inclusion criteria. Associations between health literacy and preventative cancer behaviours were the most widely examined outcome (N=55, 38%). Post treatment behaviours were the least commonly examined outcome (N=5, 3%). While mixed results were prevalent in the literature, inadequate health literacy was often found to be associated with a myriad of unfavorable health outcomes. A large breadth of health literacy tools was additionally used in the evaluation of health literacy, suggesting that existing measures are inadequate or incomplete, and that no existing measure holistically assess the construct. This review provides a detailed account of the associations between health literacy and cancer in the literature. Health literacy impacts cancer patients’ behaviours and health care service use. Future research is required to advance this field, in order to develop best-practices for health literacy evaluation and to produce programs and policies that aim to enhance patient outcomes.

Background To date, little research has examined the quality of life and cancer-associated needs of bladder cancer patients. The objective of the current study was to assess the quality of life (QoL), informational needs, and supportive care needs (SCN) in a large sample of muscle invasive (MIBC) and non-muscle invasive (NMIBC) bladder cancer survivors across the treatment trajectory (newly diagnosed and undergoing treatment, post-treatment follow-up, and treatment for advanced/recurrent disease). Methods Questionnaires were distributed to a convenience sample of patients registered with Bladder Cancer Canada, the Princess Margaret Cancer Centre, or The Ottawa Hospital. Eligibility criteria included being > 18 years of age, English-speaking, and diagnosed with bladder cancer. The questionnaire included an adapted tool to measure informational needs, and validated measures for QoL (Bladder Utility Symptom Scale, BUSS) and SCN (Cancer Survivors’ Unmet Needs Measure, CaSUN). QoL scores and unmet needs were calculated and compared between disease groups and cancer trajectory groups. Results and limitations Of the 1126 surveys distributed, 586 were completed (response = 52%). Mean age was 67.3 ± 10.2 years, and 401 participants (68.7%) were male. The mean QoL score (BUSS) for the sample was 78.1 ± 17.9 (median 81.7). Respondents with MIBC had significantly lower QoL scores compared to NMIBC. Further, scores differed across the cancer phase groups with the follow-up surveillance group having significantly higher QoL scores compared to the newly diagnosed and advance/recurrent disease groups. The ten most highly ranked informational needs were from the medical, physical, and practical domains. Eighty-eight percent (95% CI 85–91%) of respondents reported at least one SCN, with a median of 12. Over half of the participants (54%, 95% CI 49–59%) had at least one unmet need and 15% had ≥ 10 unmet needs. Newly diagnosed participants had the highest number of unmet needs. Conclusion We found that the number of unmet supportive care needs and quality of life differed across cancer trajectory and disease groups. Future efforts should focus on the development and evaluation of tailored resources and programs to address the needs of people diagnosed and treated for BC.