Health literacy and the use of digital tools in older patients with cancer and their younger counterparts: A multicenter, nationwide study

Objectives: To evaluate health literacy (HL), assess the use of digital tools/sources, and identify factors associated with low or moderate HL in older (aged ≥65) and younger (18−64) patients with cancer. Methods: A cross-sectional multicenter study including patients with cancer was conducted in 26 centers in France. HL was assessed using the Functional, Communicative and Critical Health Literacy (FCCHL) scale. Factors associated with low/moderate HL (score<median) were studied using logistic regression models. Results: The population comprised 669 patients aged 18–64 and 658 patients aged 65 +. The older patients used digital tools less than younger patients did. The median overall HL score was: 3.7 and 3.6, for younger and older patients respectively. The need for help to fill out the questionnaire was associated with low/moderate HL in both age groups. Then, older age and living in rural area were associated with low/moderate HL in younger patients only, and rare internet use in older patients. Conclusion: This article highlights the importance of considering HL in care management, as well as whom patients may present higher risk of low HL. Practice implications: It is crucial to assess HL in patients with cancer, and then to seize every opportunity to enhance HL.