The association between health literacy and cancer screening participation: A cross-sectional study across three organised screening programmes in Denmark

Objective: Health literacy may be related to non-participation in cancer screening, but there is limited understanding of its association with participation across all cancer screening programmes. This study aims to explore the associations between health literacy and advancing in participation in cancer screening programmes. Methods: We conducted a cross-sectional study involving women aged 53–65 years residing in Denmark on 31 March 2018. Data utilised was from population registries and self-reported health literacy (HLS-EU-Q16) collected autumn 2017. Uni- and multivariate ordinal logistic regression models were employed to assess associations between health literacy levels and the likelihood of increased attendance in cancer screening programmes. Results were presented as odds ratios (ORs) with 95 % confidence intervals (CIs). Results: Of the women included, 2668 (69.8 %) responded to the health literacy questionnaire. Among these, 53.3 % demonstrated adequate health literacy, 34.4 % had problematic, and 12.3 % inadequate. In total, 71.2 % attended three screening programmes, 20.1 % attended two, 6.2 % attended one, and 2.5 % attended none. There were no differences in the ORs for advancing in screening attendance when comparing problematic (OR = 1.18, 95 % CI: 0.97–1.42) or inadequate (OR = 0.96, 95 % CI: 0.74–1.26) health literacy levels with an adequate level. Conclusions: Our study suggests that health literacy does not significantly influence cancer screening participation among the studied population in Denmark. Therefore, interventions aimed at increasing screening participation in this group should not only target health literacy but also focus on other aspects of non-participation.