Head and Neck Cancer Patients' Health Literacy: A Systematic Review and Meta‐Analysis

BACKGROUND: Head and neck cancer (HNC) is rising globally and linked to poor clinical outcomes. Health Literacy (HL) could potentially have a role throughout the HNC pathway. METHODS: Following PRISMA, this review assessed HL impact in HNC. Five databases and gray literature were searched for observational studies. Descriptive analysis and proportional meta-analyses were performed. RESULTS: Of the 70 studies, 11 met the inclusion criteria (2153 HNC patients), mostly from the USA (n = 7). The Brief Health Literacy Screen was the most used tool (n = 6). The post-treatment phase and quality of life (QoL) were the main outcomes studied. Inadequate HL (11.9%-47%) was more common among men, laryngeal cancer, and advanced HNC, reducing post-treatment adherence and delaying postoperative radiotherapy. Adequate HL was associated with higher education, better QoL, better health-promoting lifestyle, and shorter time to diagnosis. CONCLUSIONS: HL influences diagnostic timelines, overall QoL, and post-treatment phase. However, its role in prevention, screening, and survival remains understudied.