Cancer survivors' health-related Internet use: Implications on equity of cancer care

Background: Increasing prevalence of Internet and new technologies are changing the communication pattern for patients and caregivers across the cancer care continuum. Although research has begun to document general Internet penetration in the US, little is known on how cancer survivors utilize online communication media for health-related purposes. This knowledge is crucial in developing effective communication technologies to achieve quality and equitable cancer care. Aims and methods: This study analyzes data from 3 iterations (2003-2005-2007) of the Health Information National Trends Survey(HINTS) to: 1) compare health-related Internet use (hereafter HRIU) between individuals with and without a cancer diagnosis , 2) report trends, prevalence and user profiles of HRIU, including support group participation, emailing provider, and buying medicine online. Descriptive analyses and weighted multivariate logistic regression analyses were performed. Results: Survivors are less likely to access Internet than those without a cancer diagnosis, although a significant increase in penetration and in HRIU is found across three survey periods, with emailing provider and buying medicine online experiencing the most significant growth. Overall, 27.5% of Internet-accessing cancer survivors have used at least one form of HRIU. Among predictor variables, education and self-rated general health are most significant factors associated with HRIU. Conclusions: Preliminary analysis suggests an increasing trend in HRIU for survivors; however, it also points to a persistent digital divide, as more educated survivors are more likely to engage in HRIU. In an effort to increase equity in communication and cancer care, technology literacy and other system-level factors must be considered.