Trends of online patient-provider communication among cancer survivors from 2008 to 2017: a digital divide perspective

  • Shaohai JiangEmail author
  • Y. Alicia Hong
  • Piper Liping Liu



In the past decade, online patient-provider communication (OPPC) has emerged as a viable avenue for cancer survivors to communicate with their providers. However, little is known about the patterns of OPPC among cancer survivors. Thus, the current study aims to explore the trend of OPPC used by cancer survivors, and the influence of digital divide on OPPC in the past decade.


Data from the 2008, 2011, 2013, and 2017 iterations of the nationally representative survey of Health Information National Trends Survey (HINTS) were analyzed. Only cancer survivors were included in the analyses. Descriptive analyses and multivariate regressions were performed.


Email has been the most typical means of OPPC; its adoption rate has increased from 9.7 to 36.6% in the past 10 years. More options for OPPC (e.g., mobile app, social medial, video conferencing, electronic health records) have been adopted since 2013. Physical Internet access was a significant predictor of OPPC over the four iterations, while cognitive access failed to predict OPPC in all the four waves. The effect of socio-demographic access varied vastly across iterations, with greater influences in 2017.


This study illustrates an increasing trend in OPPC use among cancer survivors. Significant digital divide barriers also exist in the adoption and diffusion of OPPC.

Implications for Cancer Survivors

OPPC is an important communication channel for cancer survivors and will become more important in the digital era. Targeted interventions to address the digital divide barriers affecting OPPC could be developed to benefit underserved cancer survivors and to bridge health disparities.


Online patient-provider communication Digital divide Cancer survivors Cancer communication Trend analysis 



This study was funded by Start-up Grant from National University of Singapore, and the PESCA award and T3 award from the Texas A&M University.

Compliance with ethical standards

Conflict of interest

Shaohai Jiang declares that he has no conflict of interest. Y. Alicia Hong declares that she has no conflict of interest. Piper Liping Liu declares that she has 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.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Communications and New MediaNational University of SingaporeSingaporeSingapore
  2. 2.School of Public HealthTexas A&M UniversityCollege StationUSA

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