Study Criticizes Quality of Some Cancer Web Sites

Sites focusing on alternative care can be biased, unreliable

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HealthDay Reporter

THURSDAY, April 15, 2004 (HealthDayNews) -- Many popular cancer sites on the Internet contain misleading information, especially those focused on complementary or alternative cancer therapies, a new study says.

In fact, the British researchers who conducted the study are urging that the United Kingdom government implement a "seal of approval" system that would help distinguish quality health sites from biased, bogus ones.

"Although full monitoring might not be achievable, a government 'seal of approval' is possible and very much encouraged," said study co-author Dr. Katja Schmidt of the Universities of Exeter and Plymouth.

The study appears in the April 14 issue of the Annals of Oncology.

Recent studies suggest that more than half of the world's estimated 600 million Internet users turn to the Web for health information. While many sites excel at providing the public with quality health information, others fall far short.

Dr. Ted Gansler, director of medical content at the American Cancer Society, said sites focused on non-conventional therapies are particularly prone to misleading claims and outright quackery.

"There are some sites that are clearly bogus and have no scientific basis, but there are others that can be more subtly biased by only including positive reports" on a given therapy, he explained.

But just how widespread is the problem?

To find out, Schmidt and her colleague Dr. Edzard Ernst plugged in the words "complementary," "alternative medicine" and "cancer" into some of the world's most popular search engines -- portals such as Google, Yahoo and MSN. Then they assessed the quality and accuracy of data gleaned from 32 of the most frequently cited English-language Web sites selected in those searches.

There's good news and bad news for health-conscious Web surfers, Schmidt said. Overall, the sites were of "generally good quality," she said, with academic and government sites such as those run by the U.S. National Cancer Institute, the University of Texas' MD Anderson Cancer Center and Columbia University placing near the top. Other sites, such as,, and also scored high marks for ease of access, accuracy and safety, she said.

Many Web sites scored poorly, however. About one in every six sites (16 percent) actively discouraged patients from using conventional cancer treatments such as radiation or drug therapy, suggesting they rely instead on dubious alternative therapies. Three percent of the sites urged patients to disregard their doctor's advice altogether, the researchers report.

Web sites focused on alternative medicines also tended to replace sound scientific data with opinion from so-called "experts" or inspiring anecdotes detailing "miracle" cures, Schmidt said.

"All users of Web sites should pay attention to language and be careful when extreme language is being used," Schmidt warned. "Attention should always be paid to whether the site references any sources of [scientific] information, and whether the qualifications of the authors/group of authors is given."

Gansler agreed, adding that Web users should ask themselves specific questions before acting on advice taken from the Internet: "Is the information evidence-based and are the references available? Does the person writing the content have appropriate training and experience to suggest that they're an expert? And do they have any commercial conflict of interest in promoting a product?"

Gansler pointed out that in the United States, alternative therapies such as supplements are regulated as foods, not drugs, by the U.S. Food and Drug Administration.

"For that reason they are permitted to make claims regarding health," he explained. "They're able to say, for example, that a supplement might 'improve prostate health,' but they're not permitted to say that it will cure prostate cancer."

It may be tough to enforce adequate rules on the Internet, however. Sites examined in the new study frequently described alternative cancer therapies such as coenzyme Q10, shark cartilage, laetrile and mistletoe as cancer "cures" -- even though no scientific basis for any of these claims exists.

The challenge, according to experts, is to find a quick and easy way to alert Web users that a site meets quality standards. Schmidt admitted that comprehensive monitoring and regulation of Internet health sites is "almost impossible." However, more than 3,000 health Web sites are already voluntary members of the nonprofit Health on the Net Foundation's HON Code, which attempts to grade Web sites on the quality of information provided.

These types of initiatives are "an important step toward improving the quality of health information on the Internet," Gansler said.

In the meantime, people seeking quality information on cancer care should head first to government or nonprofit sites, such as those run by the National Cancer Institute, or major cancer hospitals such as New York's Memorial Sloan-Kettering Cancer Center, Gansler said.

It's also "extremely important for patients to discuss any complementary and alternative methods with their physician," he said.

"There may be significant interactions with the conventional therapies that they're taking that their doctor would know about," he explained. The unsupervised mixing of alternative therapies with conventional treatments "could result in either serious complications or decreased effectiveness of conventional therapies," Gansler warned.

More information

To learn more about cancer care, visit the National Cancer Institute and the American Cancer Society.

SOURCES: Katja Schmidt, M.D., Penninsula Medical School, Universities of Exeter & Plymouth, Exeter, England; Ted Gansler, M.D., director, medical content, American Cancer Society, Atlanta; April 14, 2004, Annals of Oncology

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