Lung Cancer Screening Guidelines: How Readable Are Internet-Based Patient Education Resources?

AJR Am J Roentgenol. 2018 Jul;211(1):W42-W46. doi: 10.2214/AJR.17.19042. Epub 2018 Apr 30.


Objective: Following the findings of the National Lung Screening Trial, several national societies from multiple disciplines have endorsed the use of low-dose chest CT to screen for lung cancer. Online patient education materials are an important tool to disseminate information to the general public regarding the proven health benefits of lung cancer screening. This study aims to evaluate the reading level at which these materials related to lung cancer screening are written.

Materials and methods: The four terms "pulmonary nodule," "radiation," "low-dose CT," and "lung cancer screening" were searched on Google, and the first 20 online resources for each term were downloaded, converted into plain text, and analyzed using 10 well-established readability scales. If the websites were not written specifically for patients, they were excluded.

Results: The 80 articles were written at a 12.6 ± 2.7 (mean ± SD) grade level, with grade levels ranging from 4.0 to 19.0. Of the 80 articles, 62.5% required a high school education to comprehend, and 22.6% required a college degree or higher (≥ 16th grade) to comprehend. Only 2.5% of the analyzed articles adhered to the recommendations of the National Institutes of Health and American Medical Association that patient education materials be written at a 3rd- to 7th-grade reading level.

Conclusion: Commonly visited online lung cancer screening-related patient education materials are written at a level beyond the general patient population's ability to comprehend and may be contributing to a knowledge gap that is inhibiting patients from improving their health literacy.

Keywords: lung cancer screening; patient education; pulmonary nodule; readability.

MeSH terms

  • Comprehension*
  • Early Detection of Cancer
  • Health Literacy
  • Humans
  • Internet*
  • Lung Neoplasms / diagnostic imaging*
  • Patient Education as Topic*
  • Practice Guidelines as Topic*
  • Tomography, X-Ray Computed*