Zacharoula Sidiropoulou, Senior Consultant Breast Surgical Oncologist at Hospital São Francisco Xavier, shared on LinkedIn:
“Station six: awareness is not literacy.
Awareness campaigns have worked. Ask women, whether breast cancer exists, whether it is common, whether finding it early matters. Most know. Forty years of pink have achieved something important. Though awareness alone was never and will never be enough.
Knowing that breast cancer exists does not tell a woman what to do with the report she has just received. It does not explain what ‘recall for further assessment’ means or why it does not necessarily mean cancer. Neither help her navigate from an abnormal mammogram to an appointment, understand the choices between breast conservation and mastectomy, or know which questions she has a right to ask.
In Portugal’s 2019-2021 Health Literacy Survey, 29.5% of adults had low general health literacy and 65.5% had low navigational health literacy.
That is not just difficulty reading. It is difficulty finding, understanding and using the healthcare system itself. Now compare that with what healthcare routinely asks patients to navigate:
- Screening invitations.
- Consent forms.
- Appointments.
- Pathology reports.
- Treatment choices.
- Discharge letters.
The mismatch is real. A 2024 systematic review of breast cancer patient information found an average readability level of grade 11.8, almost twice the sixth-grade level commonly recommended for patient materials. We transmit information and record that it was given. That is not the same as knowing that it was understood.
Through the value lens, health literacy stops being a soft skills topic. Every station in this pathway depends on a woman being able to use what the system gives her.
A fast diagnosis creates less value, if she cannot understand what happens next. A tumour board may produce an excellent recommendation, but that recommendation still has to survive translation into a consultation in which a woman can genuinely participate.
Health Literacy is part of the mechanism through which the pathway creates value, often in remarkably simple and low-cost way. As healthcare professionals, we have a duty not only to inform our patients, but to communicate in ways they can genuinely understand and use.
Back in 2012, when I worked on the Portuguese version of the National Comprehensive Cancer Network (NCCN) patient guidelines, the principle was simple: the science already existed. The task was making it usable. None of this requires a new tech.
It requires deciding that comprehension is a clinical outcome, not a courtesy.
Pink October is a month away. It will produce a great deal of awareness. I doubt it will produce a single call-back rewritten letter. On Wednesday: the referral and what it costs to guarantee that ‘urgent’ actually means something.
Disclosure: The knowledge, perspective, thinking, and final voice are mine; GPT created the image.”
You can also read ‘UICC Staff Join Pink October to Raise Awareness About Early Detection‘
