56% of NCI-recommended cancer websites lack adequate info about PSA screening

National Cancer Institute-designated websites publish lower-quality information about prostate cancer screenings than sites run by major allied organizations like the Centers for Disease Control and Prevention or the Prostate Cancer Foundation, according to a report published this month in Practical Radiation Oncology.

“An informed decision about prostate cancer screening requires knowledge of risk, the screening process, potential outcomes and management of prostate cancer,” corresponding author Caleb R. Dulaney, MD, and colleagues wrote in PRO. “Many men use the internet to inform these complex decisions.”

But reliable resources may be harder to come by than some might expect, the authors, of the University of Tennessee and University of Alabama at Birmingham, said. To evaluate the accessibility and quality of information about prostate-specific antigen (PSA) testing on NCI-recommended sites, Dulaney and his team reviewed the Dec. 1, 2016, versions of 63 NCI-designated cancer center public websites against five online clearinghouses from allied organizations, including CDC.gov, cancer.org and USPSTF.org. 

Sites were graded by two blinded reviewers, Dulaney et al. wrote, and were analyzed according to a 50-item list of validated healthcare information quality measures. Upon initial analysis, 90 percent of the websites addressed PSA screening in some way.

Cancer center sites covered 45 percent of the items on the researchers’ checklist, they said, but organization websites topped that number with 70 percent coverage. All organizational sites also addressed the possibilities of false-positive results, while cancer center sites did the same just 41 percent of the time. Cancer center sites addressed when PSA testing is needed 44 percent of the time (28 of 63 sites).

“More than one-half of NCI-designated center websites failed to discuss when PSA testing should be performed, the possibility of false-positive results or appropriate next steps after detection of an elevated PSA value,” Dulaney and his co-authors said. “Similar weaknesses have also been highlighted with respect to prostate cancer treatment information.”

Information available on center websites was also less accessible to a modern U.S. population, the researchers wrote. Around 60 percent of those sites were easily viewed on a mobile device—which is the way the majority of Americans assume online content—and PSA screening information was available in Spanish just 18 percent of the time. Organization websites, on the other hand, excelled where center sites didn’t.

“NCI-designated cancer websites publish lower-quality public information about PSA screening than sites run by major allied organizations,” the authors wrote. “Nonetheless, information and communication deficiencies were observed across all surveyed sites.”

The blinded reviewers in this study rated 6 percent of cancer center webpages as “superior,” Dulaney and colleagues said, meaning the information provided addressed more than 75 percent of topics on the team’s checklist. Twenty percent of organizational websites were rated in that category, but the authors said sites could be vastly improved with the addition of specific information about prostate cancer risk and the potential outcomes of PSA screening. Standardizing web-based cancer resources could be a good stepping-off point for promoting shared decision-making in clinical practice, they said. 

“In an age of increasing patient consumerism, prospective prostate cancer patients would benefit from improved online PSA screening information from provider and advocacy organizations,” Dulaney et al. wrote. “Validated cancer patient web educational standards remain an important, understudied priority.”