Online nutrition information for cancer survivors

Background: This research aims to systematically review a comprehensive sample of websites (English-language) that provide information on nutrition after cancer treatment. Methods: In consultation with cancer survivors and experts, we developed search strings for an internet search (incognito mode in Google Chrome) to be completed in six English-speaking countries (Ireland, the United Kingdom, Australia, New Zealand, Canada and the United States); the first 10 results were chosen for each search). Websites/web pages were included if the links related to sites/content that provided information on health post-treatment in English and aimed at adults (aged above 18 years). Several tools were applied to test the quality, readability and usability of the websites/weblinks. Results: Initially, 720 links were found, with 159 eligible for inclusion. Those eligible for review were charity/support/non-governmental organisation weblinks (49.1%) that originated in the United States (42.8%) and did not specify a particular cancer type (65.4%). One-third (n = 59, 37.1%) of these links contained nutrition guidance; however, these lacked practical implementation strategies. Most of the websites/web pages were not Health On the Net certified and lacked overall quality, with a mean International Patient Decision Aids Standards score of 20.4/40 and a Journal of the American Medical Association score of 1/4. Readability failed to meet ideal levels. Only 32.5% (n = 13) of the web pages/weblinks met the benchmark for usability. Conclusion: Cancer survivors seeking nutrition information online may encounter difficulty locating advice, and where they do, it is unlikely to contain guidance on implementation into day-to-day life. This is concerning, given the important role nutrition can play in cancer survivorship.