Journal of Cancer Research and Clinical Oncology

, Volume 144, Issue 9, pp 1843–1850 | Cite as

EHealth literacy in patients with cancer and their usage of web-based information

  • Hanna Heiman
  • Christian Keinki
  • Jutta HuebnerEmail author
  • On Behalf of Working Group Prevention and Integrative Oncology of the German Cancer Society
Original Article – Clinical Oncology



Our aim was to learn more about the association between the sources of information cancer patients and caregivers use and their eHealth literacy.


We distributed a standardized questionnaire among participants of a lecture program on complementary and alternative medicine (CAM).


Among 182 attendants, the Internet was the third most important source of information (57%), preceded by the oncologist (67%) and print media (61%). Print media was associated with female participants and web-based information with younger ones. Regarding eHealth literacy, more than half (58.5%) had an above average eHEALS score. Nevertheless, the biggest concern was not being able to differentiate between reliable and not reliable websites. The correlation between a high eHealth literacy and regular search of web-based cancer information was significant (p < 0.001).


The number of people using the Internet as a source of cancer information has increased over the past years and will rise in the future. However, only half of the population has the knowledge and capability to access and differentiate the massive web-based data. Improving eHealth literacy within the public will expand the knowledge of regular patients and help them become a well-informed and equal partner in decision making.


Cancer eHealth literacy Health information Internet 



This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. According to the rules of the ethics committee at the University Hospital of the J.W. Goethe University at Frankfurt/Main, due to anonymity no ethics vote was necessary.


  1. Amelang M, Bartussek D (2001) Differentielle Psychologie und Persönlichkeitsforschung [Differential psychology and personality research]. Kohlhammer, StuttgartGoogle Scholar
  2. Collins SA, Currie LM, Bakken S et al (2012) Health literacy screening instruments for eHealth applications: a systematic review. J Biomed Inform 45:598–607. CrossRefPubMedPubMedCentralGoogle Scholar
  3. Davies E, Yeoh K-W (2012) Internet chemotherapy information: impact on patients and health professionals. Br J Cancer 106:651–657. CrossRefPubMedPubMedCentralGoogle Scholar
  4. Ebel M-D, Stellamanns J, Keinki C et al (2017) Cancer patients and the internet: a survey among German cancer patients. J Cancer Educ Off J Am Assoc Cancer Educ 32:503–508. CrossRefGoogle Scholar
  5. Feufel MA, Stahl SF (2012) What do web-use skill differences imply for online health information searches? J Med Internet Res 14:e87. CrossRefPubMedPubMedCentralGoogle Scholar
  6. Gale CR, Deary IJ, Wardle J et al (2015) Cognitive ability and personality as predictors of participation in a national colorectal cancer screening programme: the English longitudinal study of ageing. J Epidemiol Commun Health 69:530–535. CrossRefGoogle Scholar
  7. Huebner J, Ebel M, Muenstedt K et al (2015) A lecture program on complementary and alternative medicine for cancer patients–evaluation of the pilot phase. J Cancer Educ Off J Am Assoc Cancer Educ 30:340–343. CrossRefGoogle Scholar
  8. James N, Daniels H, Rahman R et al (2007) A study of information seeking by cancer patients and their carers. Clin Oncol R Coll Radiol G B 19:356–362. CrossRefGoogle Scholar
  9. Keinki C, Seilacher E, Ebel M et al (2016) Information needs of cancer patients and perception of impact of the disease, of self-efficacy, and locus of control. J Cancer Educ Off J Am Assoc Cancer Educ 31:610–616. CrossRefGoogle Scholar
  10. Laurent MR, Cremers S, Verhoef G, Dierickx D (2012) Internet use for health information among haematology outpatients: a cross-sectional survey. Inform Health Soc Care 37:62–73. CrossRefPubMedGoogle Scholar
  11. Lee K, Hoti K, Hughes JD, Emmerton LM (2015) Consumer use of “Dr Google”: a survey on health information-seeking behaviors and navigational needs. J Med Internet Res 17:e288. CrossRefPubMedPubMedCentralGoogle Scholar
  12. Liebl P, Seilacher E, Koester M-J et al (2015) What cancer patients find in the internet: the visibility of evidence-based patient information—analysis of information on German websites. Oncol Res Treat 38:212–218. CrossRefPubMedGoogle Scholar
  13. Mitsutake S, Shibata A, Ishii K, Oka K (2012) Association of eHealth literacy with colorectal cancer knowledge and screening practice among internet users in Japan. J Med Internet Res 14:.
  14. Norman CD, Skinner HA (2006a) eHealth literacy: essential skills for consumer health in a networked world. J Med Internet Res 8:e9. CrossRefPubMedPubMedCentralGoogle Scholar
  15. Norman CD, Skinner HA (2006b) eHEALS: the eHealth Literacy Scale. J Med Internet Res 8:e27. CrossRefPubMedPubMedCentralGoogle Scholar
  16. Rammstedt B, Kemper CJ, Klein MC et al (2017) A short scale for assessing the big five dimensions of personality: 10 item big five inventory (BFI-10). Methods Data Anal 7:17. CrossRefGoogle Scholar
  17. Rider T, Malik M, Chevassut T (2014) Haematology patients and the Internet–the use of on-line health information and the impact on the patient-doctor relationship. Patient Educ Couns 97:223–238. CrossRefPubMedGoogle Scholar
  18. Robert-Koch-Institut (2017) Krebs in Deutschland für 2013/2014 [Cancer in Germany 2013/2014]. Robert Koch-Institut, BerlinGoogle Scholar
  19. Sabel MS, Strecher VJ, Schwartz JL et al (2005) Patterns of Internet use and impact on patients with melanoma. J Am Acad Dermatol 52:779–785. CrossRefPubMedGoogle Scholar
  20. Smith RP, Devine P, Jones H et al (2003) Internet use by patients with prostate cancer undergoing radiotherapy. Urology 62:273–277CrossRefPubMedGoogle Scholar
  21. Ziebland S, Chapple A, Dumelow C et al (2004) How the internet affects patients’ experience of cancer: a qualitative study. BMJ 328:564. CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Medizinische Klinik II, Hämatologie und Internistische OnkologieUniversitätsklinikum JenaJenaGermany

Personalised recommendations