The American Medical Association recommends that medical education materials be written at a sixth-grade reading level or lower, but a recent study found that the average reading level for oncology education materials ranged from 8.8 to 14.8.
The study, published in JAMA Otolaryngology–Head & Neck Surgery, reviewed literature from Cochrane, PubMed and Scopus published between 1995 and 2024 using keywords such as "head and neck cancer," "readability," "health literacy" and related terms. Full-text studies were evaluated for readability using tools including the Flesch-Kincaid Grade Level and Flesch Reading Ease.
Seventeen studies assessed the readability of 1,124 patient education materials on head and neck cancers. The average reading grade ranged from 8.8 to 14.8, and none of the studies reported a mean grade of 6 or lower.
Eight studies found that health literacy rates ranged from 11.9% to 47%.
The findings indicate that about one-third of patients did not have adequate health literacy and none of the patient education materials was developed at a sixth-grade reading level or lower, as recommended by the AMA. The gap highlights a need to improve readability to enhance patient understanding and reduce barriers to shared decision-making.