Prevalence of low cost-related health literacy among colorectal cancer survivors: Findings from the kentucky cancer registry

Jean S. Edward, Mary Kay Rayens, Robin C. Vanderpool

Research output: Contribution to journalArticlepeer-review


BACKGROUND: The lack of research on costrelated health literacy among colorectal cancer (CRC) survivors warrants further evaluation. OBJECTIVES: The objective of this study was to examine prevalence of low literacy (health, cancer, and insurance literacy), and numeracy and their association with sociodemographic factors in a group of Kentucky CRC survivors. METHODS: Based on data from the Kentucky Cancer Registry, this cross-sectional study evaluated survey results from January 2019 to November 2019 for the prevalence of low cost-related health literacy. FINDINGS: Overall, 104 participants had adequate health literacy (77%) and cancer health literacy (71%). However, fewer CRC survivors had high numeracy (16%) and confidence in choosing and using health insurance (18%). Thirty-one percent reported competence in their ability to select a health insurance plan and use it to access timely and appropriate healthcare services. Those with lower levels of education or those enrolled in a public health insurance plan were more likely to have lower health literacy, insurance literacy, and numeracy.

Original languageEnglish
Pages (from-to)413-420
Number of pages8
JournalClinical Journal of Oncology Nursing
Issue number4
StatePublished - Aug 2022

Bibliographical note

Funding Information:
Jean S. Edward, PhD, RN, CPHE, is an assistant professor in the College of Nursing and a nurse scientist at University of Kentucky Healthcare Markey Cancer Center, and Mary Kay Rayens, PhD, is a professor in the College of Nursing, both at the University of Kentucky in Lexington; and Robin C. Vanderpool, DrPH, is an associate professor in the College of Public Health at the University of Kentucky in Lexington and a branch chief at the National Cancer Institute in Rockville, MD. Edward can be reached at, with copy to CJONEditor@ons .org. (Submitted January 2022. Accepted April 20, 2022.) This research was supported by the grant #IRG 16-182-28 from the American Cancer Society and the Behavioral and Community-Based Research Shared Resource Facility of the University of Kentucky Markey Cancer Center (P30CA177558).

Publisher Copyright:
© 2022, Oncology Nursing Society. All rights reserved.


  • Cost-related health literacy
  • Health insurance literacy
  • Numeracy
  • Survivorship

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)


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