Systematic Review of Internet Patient Information on Colorectal Cancer Surgery

BACKGROUND: Patients diagnosed with colorectal cancer often seek information on the Internet to help them make treatment decisions. OBJECTIVE: The aim of this study is to evaluate the quality of Web-based patient information regarding surgery for colorectal cancer. DESIGN: This study is a cross-sectional survey of patient-directed Web sites. SETTINGS: The search engine Google (Mountain View, CA) and the search terms "colorectal cancer surgery," "colon cancer surgery," and "rectal cancer surgery" were used to identify Web sites. MAIN OUTCOME MEASURES: To assess quality, we used the DISCERN instrument, a validated questionnaire developed to analyze written consumer health information on treatment options to aid consumers in evaluating the quality of health-related information on treatment choices for a specific health problem. An additional colorectal cancer-specific questionnaire was used to evaluate Web site content for colorectal cancer surgical treatment. Two independent assessors reviewed each Web site. RESULTS: Searches revealed a total of 91 distinct Web sites, of which 37 met inclusion criteria. Web site affiliation was as follows: 32% open-access general information, 24% hospital/health care organization, and 19% professional medical society. Twelve (32.4%) Web sites had clear aims, 10 (27.0%) had identifiable references to their sources of information, and 9 (24.3%) noted the date of published information. Ten sites (27.0%) provided some description of the surgical procedure, 8 (21.6%) discussed either the risks or the benefits of surgery, and 4 (10.8%) addressed quality-of-life issues. Nineteen (51.4%) Web sites discussed postoperative complications, and 7 (18.9%) discussed stoma-related maintenance/care. LIMITATIONS: The small sample size and interrater reliability bias are limitations of this study. CONCLUSIONS: The quality of online patient information regarding colorectal cancer treatment is highly variable, often incomplete, and does not adequately convey the information necessary for patients to make well-informed medical decisions regarding treatment for colorectal cancer. An opportunity exists for professional medical societies to create more comprehensive online patient information materials that may serve as a resource to physicians and their patients (see Video, Supplemental Digital Content 1, http://links.lww.com/DCR/A122).