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Websites on Bladder Cancer: an Appropriate Source of Patient Information?


A growing number of patients search for health information online. An early investigation of websites about bladder cancer (BCa) revealed mostly incomplete and particularly inaccurate information. We analyzed the quality, readability, and popularity of the most frequented websites on BCa. An Internet search on was performed for the term “bladder cancer.” After selecting the most frequented websites for patient information, HONcode quality certification, Alexa popularity rank, and readability scores (according to US grade levels) were investigated. A 36-point checklist was used to assess the content according to the EAU guidelines on BCa, which was categorized into seven topics. The popularity of the 49 websites analyzed was average, with a median Alexa popularity rank of 41,698 (interquartile range [IQR] 7–4,671,246). The readability was rated difficult with 11 years of school education needed to understand the information. Thirteen (27%) websites were HONcode certified. Out of 343 topics (seven EAU guideline topics each on 49 websites), 79% were mentioned on the websites. Of these, 10% contained incorrect information, mostly outdated or biased, and 34% contained incomplete information. Publically provided websites mentioned more topics per website (median [IQR] 7 [5.5–7] vs. 5.5 [3.3–7]; p = 0.022) and showed less incorrect information (median [IQR] 0 [0–1] vs. 1 [0–1]; p = 0.039) than physician-provided websites. Our study revealed mostly correct but partially incomplete information on BCa websites for patients. Physicians and public organizations should strive to keep their website information up-to-date and unbiased to optimize patients’ health literacy.

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Fig. 1



Bladder cancer


European Association of Urology


Interquartile rage


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Correspondence to Johannes Salem.

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The authors declare that they have no conflict of interest.

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1. Online health information on bladder cancer is mostly mentioned correctly, and selected websites can serve as an appropriate source of patient information.

2. Improvement of readability and completeness of the given information is needed.

3. Physicians and public organizations should strive to keep their website information up-to-date and unbiased.

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Salem, J., Paffenholz, P., Bolenz, C. et al. Websites on Bladder Cancer: an Appropriate Source of Patient Information?. J Canc Educ 34, 381–387 (2019).

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  • Internet information
  • Guidelines
  • Patient information
  • Bladder cancer
  • New media
  • Websites
  • Patient education
  • Health literacy