Li Yan, Ye Shan, Zhou Yidong, Mao Feng, Guo Hailing, Lin Yan, Zhang Xiaohui, Shen Songjie, Shi Na, Wang Xiaojie, Sun Qiang
Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
J Med Internet Res. 2020 Apr 17;22(4):e16768. doi: 10.2196/16768.
The internet allows patients to easily look for health information. However, how Chinese patients with breast cancer use the internet has rarely been investigated, and there is a scarcity of information about the influence of internet use on survival.
This observational study aimed to investigate the details of online medical information searching by Chinese patients with breast cancer and to determine whether internet use has any survival benefits.
Patients who were diagnosed with invasive breast cancer at Peking Union Medical College Hospital between January 2014 and December 2015 were enrolled. We obtained information on their internet-searching behavior and gathered data from the patients' medical and follow-up records. The associations between internet use and other clinic-pathological factors were analyzed. A Cox proportional-hazards model and the Kaplan-Meier method were used for disease-free survival (DFS) analyses.
A total of 973 patients with invasive breast cancer who underwent definitive surgery took part in the study. Among them, 477 cases (49.0%) performed web-based breast cancer information searching before the initial treatment. A multivariate logistic regression analysis suggested that web-based breast cancer information searching was significantly associated with younger age (odds ratio [OR] 0.95, 95% CI 0.94-0.97, P<.001), higher education level (OR 1.37, 95% CI 1.01-1.86, P=.04), and breast conserving surgery (OR 1.35, 95% CI 1.04-1.77, P=.03). Baidu (73.4%, 350/477) and WeChat (66.7%, 318/477) were the two most popular online information sources for breast cancer; however, only 44.9% (214/477) felt satisfied with the online information. In contrast to the nonweb searching group, the web-using patients who were satisfied with online information showed significantly improved DFS (hazard ratio 0.26; 95% CI 0.08-0.88, P=.03).
The patients who were most likely to search the internet for breast cancer information were younger and well-educated, and they were more likely to have breast conserving therapy. Web-using patients who were satisfied with the internet information showed significantly improved DFS. Patients should browse credible websites offering accurate and updated information, and website developers should provide high-quality and easy-to-understand information to better meet the needs of patients with breast cancer.
互联网使患者能够轻松查找健康信息。然而,中国乳腺癌患者如何使用互联网鲜少被研究,且关于互联网使用对生存影响的信息匮乏。
这项观察性研究旨在调查中国乳腺癌患者在线医疗信息搜索的细节,并确定互联网使用是否具有任何生存益处。
纳入2014年1月至2015年12月在北京协和医院被诊断为浸润性乳腺癌的患者。我们获取了他们的互联网搜索行为信息,并从患者的医疗和随访记录中收集数据。分析互联网使用与其他临床病理因素之间的关联。采用Cox比例风险模型和Kaplan-Meier方法进行无病生存(DFS)分析。
共有973例接受根治性手术的浸润性乳腺癌患者参与了该研究。其中,477例(49.0%)在初始治疗前进行了基于网络的乳腺癌信息搜索。多因素逻辑回归分析表明,基于网络的乳腺癌信息搜索与年龄较小(比值比[OR]0.95,95%可信区间0.94 - 0.97,P <.001)、教育水平较高(OR 1.37,95%可信区间1.01 - 1.86,P =.04)以及保乳手术(OR 1.35,95%可信区间1.04 - 1.77,P =.03)显著相关。百度(73.4%,350/477)和微信(66.7%,318/477)是乳腺癌最受欢迎的两个在线信息来源;然而,只有44.9%(214/477)的人对在线信息感到满意。与非网络搜索组相比,对在线信息满意的网络使用患者的DFS显著改善(风险比0.26;95%可信区间0.08 - 0.88,P =.03)。
最有可能在互联网上搜索乳腺癌信息的患者年龄较小且受过良好教育,并且他们更有可能接受保乳治疗。对互联网信息满意的网络使用患者的DFS显著改善。患者应浏览提供准确和最新信息的可信网站,网站开发者应提供高质量且易于理解的信息,以更好地满足乳腺癌患者的需求。