Colon Cancer Web Presence: Too Complex?

Popular web information on colorectal cancer (CRC) is too difficult for most lay people to read and does not address the appropriate risks to and concerns of patients, suggests a new study.

In a review of one dozen popular websites, most of the online patient education materials for CRC screening were written beyond the recommended sixth-grade reading level, while content on the sites failed to address key risks, as well as the barriers to and benefits of screening.

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"Today, the Internet often is the first point of contact between the patient and health-related information, even for patients with low literacy. It, thus, is a great opportunity for us to influence the decisions people make about their health and to steer them in the right direction. Informing patients is a physician's responsibility and we take this role seriously," said Deepak Agrawal, MD, of the University of Texas Southwestern Medical Center in Dallas.

The study, which appeared in the journal Gastrointestinal Endoscopy (2014; doi:10.1016/j.gie.2014.01.034), analyzed the appropriateness of internet-based materials in terms of health literacy.

CRC remains the second leading cause of cancer death in the United States, despite effective screening tests, including the fecal occult blood test, flexible sigmoidoscopy, and colonoscopy. Developing more appropriate and targeted patient education resources on CRC may improve patient understanding and promote screening, an important goal because colorectal cancer screening rates in the United States remain below target levels, the authors said.

Previous studies have shown that six of 10 people rely on the Internet when seeking information about colonoscopy screening. Yet, readability for 10 of the 12 sites reviewed, which were all from reputable medical societies and considered likely referral sites for physicians, were above the maximum recommended sixth-grade reading level.

In addition to being difficult for the lay-person to read, the researchers also found that the sites failed to address key concerns, such as the risk of developing CRC, the chances of dying from CRC, and the availability of screening. The review found that only half of the sites discussed CRC risk in the general population and only a quarter specifically addressed patients at high risk, such as African Americans, smokers, patients with diabetes, and obese patients.

The sites also failed to adequately address other common barriers to screening. For example, less than 10% of the sites addressed embarrassment, which is a common concern, and only a quarter of sites addressed pain associated with colonoscopy or the costs of the procedure. None specifically mentioned the need for colonoscopy when no symptoms are present.

"It is important to add that reading information on a website should not be considered a substitute for consulting a physician," Agrawal said. "Internet information is best used as a supplement. With colon cancer screening, there are many options and each has its risks and benefits. An actual discussion with a physician would help patients choose the best option."

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