Abstract
IntroductionThe aim of this study was to assess the effectiveness of visual-based education intervention on understanding cancer information.MethodsWe conducted a systematic review across PubMed, Embase and Scopus electronic databases using Preferred Reporting Items for Systematic Reviews and Meta-analysis, in July 2025. Randomized and non-randomized studies measuring impact of visual-based education interventions on health literacy, knowledge, comprehension, or understanding in cancer were considered for inclusion. Quality assessment was conducted using the Mixed Methods Appraisal Tool (MMAT). A descriptive analysis of included studies was performed, and a meta-analysis was performed for Randomised clinical trials (RCTs).ResultsTwenty-one studies were included in the review, 11 RCTs, seven non-RCTs, and three mixed methods design. The studies were conducted in seven countries across five continents. A high proportion of the included studies satisfied the MMAT quality assessment criteria. Visual-based interventions improved knowledge and comprehension compared to non-visual communication such as audio or basic text. In one study, video intervention increased knowledge with mean difference 3.96 ± 1.69 compared to pamphlet (1.76 ± 1.42). Crowd-figure-pictograms with numeric data increased knowledge by 2.42 compared to non-numeric controls (0.20). Furthermore, 3D printed models improved understanding compared to imaging alone (4.60-4.78/5 vs. 4.06-4.49/5), and visual-based treatment timelines improved comprehension compared to audio (0.84 vs 0.68). However, certain visual-based interventions had no impact over well-designed static materials in some contexts. Health literacy was a significant moderator of outcomes, and low health literacy was consistently associated with poor baseline knowledge and comprehension, regardless of visualization format.ConclusionVisual-based education interventions may improve knowledge, comprehension and understanding, overcoming barriers imposed by limited health literacy, hence empowering patients to self-manage their health across various cancer contexts.