Study Examines Colorectal Cancer Information on the Internet

The popularity of using the Internet as a source of health information has led to improvements in cancer prevention, particularly among older adults. However, the quality and quantity of health information on the Internet that focuses on cancer-related information requires further investigation.

Because little is known about how health information on the Internet influences the decisions of people eligible for colorectal cancer screening (CRC), researchers investigated the extent to which consumers are better educated about CRC screening information because of information available on the Internet. Researchers also sought to identify how better-informed consumers, with reliable and trustworthy health information, were enabled to make sound decisions regarding CRC screening [Int J Environ Res Public Health. 2014;11(1):1058-1075].

Expert groups recommend screening for CRC starting at 50 years of age, using 1 or more of the followings 3 options: annual fecal occult blood test (FOBT), flexible sigmoidoscopy every 5 years, and/or colonoscopy every 10 years.

Data for this study was taken from the 2003 Health Information National Trends Survey (HINTS), a nationally representative telephone survey of US adults aged ≥18 years by the National Cancer Institute from October 2002 to April 2003. HINTS completed telephone interviews with 6369 respondents. For this study, researchers only focused on patients aged ≥55 years, given that they were at highest risk of developing CRC and were therefore recommended to undergo regular prevention screenings. After omitting 332 observations with missing values, the final analysis included 1818 participants.

The study applied the PRECEDE-PROCEED model to understand 2 aspects of cancer-related health information on the Internet: quantity (Internet usage, seeking, and access) and quality (satisfaction, frustration, confidence, reliance, credibility, and trust). Knowledge about CRC and CRC screening was evaluated asking about knowledge of CRC prevalence, prevention, and screening strategies using the following information:

• Age to begin FOBT

• Frequency of FOBT

• Age to begin sigmoidoscopy/colonoscopy

• Frequency of sigmoidoscopy/colonoscopy

• Regular check

• Family history of CRC

The study’s findings showed that cancer-related health information from the Internet increased individuals’ health knowledge, improved their attitudes towards health, and motivated them to seek other health-risk information and health services. The higher the level of information seeking on the Internet, the greater the probability an individual had CRC screening. Specifically, 82.6% of individuals who used cancer-related health information on the Internet underwent CRC screening. Furthermore, the findings demonstrated that the amount of Internet usage was associated with a 66% increase in CRC compliance compared with individuals who used information from other sources (eg, newspapers, magazines).

Furthermore, the quality of available health information is an important criteria in consumers’ decision-making. The analysis suggested that the design and publishing Web sites concerning CRC has the potential to increases CRC screening and decrease risk behaviors if information is credible, reliable, and up-to-date.

The study also found that dissatisfying and frustrating experiences in searches for Internet-based cancer information could be barriers to getting more people to comply with CRC screening recommendations. People “who were unsatisfied with their most recent research experiences of cancer information on Internet” tended to have a lower probability of CRC screening; they had a margin of 15% less likely to comply with CRC screening compare with satisfied individuals, according to the research. “Through a reduction of dissatisfying experience of seeking cancer-related health information on the Internet, and through improvement of access to information about cancer on the Internet, individuals will be more likely to comply with CRC screening guidelines,” noted the researchers.

The researchers acknowledged study limitations. The 2003 HINTS data were cross-sectional, and this limited the investigation of behavioral changes across time. Also, the estimates of CRC screening were based on self-reported data and were restricted to the limitations inherent in self-reports.

“As shown in this study, dispersion of cancer-related information can lead to increased knowledge of cancer risk factors for consumers, which, in turn, could promote CRC and other cancer screening, particularly the [older] members of minority groups, who are at greatest risk,” according to the study authors.