Objective: The Internet provides an enormous amount of patient-orientated information on colorectal cancer. This study examined its accessibility and quality.
Methods: Sites were identified using two search engines (Google and Hotbot) and the search terms 'bowel cancer' and 'colon and rectal cancer'. The first 100 sites in each search were visited and classified. Sites that contained patient information were assessed using the 'Discern' instrument for reliability and quality of information on treatment choices.
Results: Google identified 55,700 sites for the search term 'colorectal cancer' and 214,000 for 'bowel cancer'. Hotbot produced 27,700 and 190,000, respectively. Four hundred sites were studied. Only 25 (6%) sites were duplicated in the searches. One hundred and eighteen (30%) provided information, 70 (18%) were lists of links, 27 (7%) were adverts, 22 (6%) promoted medical centres, 51 (13%) were dead links, 15 (4%) were message boards. Of the 118 that provided information 73 (62%) advised on treatment and 73 (62%) were designed for patients. The sources of information were clear in 55 (47%) and the date when this information was reported was given in only 63 (53%). By adapting the Discern instrument, sites were classified as excellent 18 (15.3%), very good 19 (16.1%), good 28 (23.7%), fair 8 (6.8%) and poor 45 (38.1%).
Conclusions: The Internet provides a wealth of information on colorectal cancer but the best sites are difficult for patients to distinguish from the thousands of sites returned by search engines. Clinicians should guide patients to quality sites to avoid confusion and misinformation.