As health care moves towards greater choice, with shared responsibility and decision making between doctors and patients, a variety of resources and skills are needed by individuals if they are to be active participants in their health. Health literacy is the ability to make the most out of health. For an individual, it is the capacity to obtain, interpret and understand basic health information and services in ways that enhance health. In developed countries, however, over half of the population have reading and comprehension difficulties, creating a gap between the educational expectations of health-care services and an individual's ability to understand. This review highlights the difficulty many cancer patients face as a consequence of their poor literacy and comprehension skills. It draws attention to a problem whose magnitude is not always easy to recognize and suggests simple ways health professionals can more effectively communicate with their patients.

A retrospective analysis of first-time enquirers using a cancer information service in Belfast, Northern Ireland, is presented. Our results show that women are three times more likely to use the service than men, with relatives and friends more likely to seek information on behalf of cancer patients than patients themselves. Unlike patients with cancer at other sites, the number of enquiries from breast cancer patients [standard incidence rate (SIR) = 1.5] was greater than incidence figures for the general population would suggest. Individuals without a cancer diagnosis but with potentially cancer-related symptoms accounted for 30% of all enquiries. Breast changes accounted for 49% of calls, testicular abnormalities 19% and concerns about cervical smear test results 13%; prostate problems (12%) and changes in skin pigmentation were the other main sources of caller concern. Our results also demonstrate that cancer patients often have a poor understanding of commonly used medical terms. This analysis shows that individuals using a cancer information service are not representative of the population that develops the disease, highlights how media campaigns can encourage the awareness and reporting of new and pre-existing symptoms, and exposes some of the confusion and misconceptions about cancer that are experienced by sections of the Irish population.

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Background. An important step in integrating dental and medical care is improving understanding of the frequency and characteristics of dental practitioners who conduct health risk assessments (HRAs). Methods. From September 2017 through July 2018, active dentist and hygienist members of the South Atlantic region of The National Dental Practice-Based Research Network (N ¼ 870) were invited to participate in a survey evaluating their HRA practices (screening, measuring, discussing, referring patients) for 6 health conditions (obesity, hypertension, sexual activities, diabetes, alcohol use, tobacco use). For each health condition, the authors used ordinal logistic regression to measure the associations among the practitioner's HRA practices and the practitioner's characteristics, barriers, and practice characteristics. Results. Most of the 475 responding practitioners (72%) reported they at least occasionally complete 1 or more HRA steps for the health conditions except sexual activities. Most practitioners screened (that is, asked about) and gave referral information to affected patients for diabetes (56%) and hypertension (63%). Factors associated with each increased HRA practice for 2 or more outcomes were non-Hispanic white compared with Hispanic practitioner (cumulative odds ratio [COR]

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