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Dis Colon Rectum. 2014 Jan;57(1):64-9. doi: 10.1097/DCR.0000000000000011.

Systematic review of internet patient information on colorectal cancer surgery.

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1Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois 2Department of Surgery, University of Toronto, Toronto, Ontario, Canada 3Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.



Patients diagnosed with colorectal cancer often seek information on the Internet to help them make treatment decisions.


The aim of this study is to evaluate the quality of Web-based patient information regarding surgery for colorectal cancer.


This study is a cross-sectional survey of patient-directed Web sites.


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.


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.


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.


The small sample size and interrater reliability bias are limitations of this study.


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,

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