Disparity in cancer literacy by socioeconomic status

BACKGROUND: Cancer literacy is a crucial component of cancer prevention, and disparities in cancer burden are observed based on socioeconomic status (SES). Evidence on the relationship between SES and cancer literacy among Chinese population is limited. This study aims to evaluate the association between SES disparities and cancer literacy. METHODS: This multicenter cross-sectional survey included 12 sites in China, employing a multistage proportional stratified cluster random sampling approach. Cancer literacy and sociodemographic information were collected through face-to-face interviews with participants aged 15 to 69 years. Cancer literacy was assessed using a validated questionnaire, with total scores ranging from 0 to 68; a score of 55 or higher indicated adequate cancer literacy. SES was defined by integrating household income, education, and occupation, with levels (low, medium, and high) determined through latent class analysis. Multivariable logistic regression was conducted to examine the association between SES and cancer literacy. RESULTS: Among 4,784 participants, 865 (18.08%) were identified as having adequate cancer literacy. The percentage of literate participants differed across SES groups, with 9.54% in the low SES, 14.11% in the medium SES, and 39.27% in the high SES. Compared to participants in the low SES group, the odds ratio (OR) for adequate cancer literacy was 4.74 (95% CI: 3.66–6.14) in the high SES group, and 1.38 (95% CI: 1.11–1.72) in the medium SES group. Subgroup analyses revealed that younger individuals, females, and urban residents with high SES exhibited significantly higher cancer literacy. Similar results were observed across five specific dimensions of cancer literacy. CONCLUSIONS: SES is a significant determinant of cancer literacy. Improving cancer literacy may enhance cancer prevention by promoting informed screening participation, earlier help-seeking, and healthier preventive behaviors, and should therefore be incorporated as a key component of cancer prevention strategies aimed at reducing SES-related disparities.