Understanding the cancer health literacy gap: NCCN member institutions’ website readability across the high mortality cancers in the US

Abstract

BackgroundThe readability of cancer educational content often exceeds the average reading level of the U.S. population. This study evaluated the readability of online educational material for the five deadliest cancers in the US. MethodsWe assessed the readability of diagnosis and treatment information across 34 NCCN member institution websites. Readability was analyzed using four validated formulas: Fry Readability Score, Flesch-Kincaid Grade Level, Gunning-Fog Index, and Simple Measure of Gobbledygook. The primary outcome was the mean organizational readability level for each resource, and secondary outcomes included differences in readability between diagnosis and treatment materials and an analysis of sentence and word complexity. ResultsThe mean readability level across 34 websites was 13 ± 1.96, equivalent to a university freshman level. Treatment materials were significantly harder to read than diagnosis materials (14 ± 1.8 vs. 12 ± 1.8, p < 0.01) across all cancers. Readability varied significantly depending on the type of cancer, with material relating to the diagnosis of pancreatic cancer requiring the highest educational level (13 ± 1.9) and material relating to treating breast cancer requiring the lowest reading proficiency (12 ± 1.7). Furthermore, the analysis demonstrated that cancer diagnosis materials contained a lower median percentage of complex and long words than treatment materials but had a higher percentage of long sentences. ConclusionsThese findings underscore the need for organizations to prioritize matching the nation’s literacy levels. Despite the growing reliance on online resources for patient education, the current readability levels hinder patient comprehension