http://hints.cancer.gov

briefs

NUMBER 16

• 2002

• 2005

• 2008

0

10

20

30

40

50

60

70

80

Doctor or Health Care

Professional

Internet

Trust in Source for Cancer or Health Information

61.4% 66.8% 68.2% 23.4% 18.5% 18.9%

In this HINTS Brief, we discuss trends in cancer information seeking.

A Decade of Change in Health Information Technologies

and Patient Engagement 

The past few decades have witnessed dramatic changes in the health

communication and informatics environment. Innovation has

expanded the availability and diversity of communication channels

and technologies, significantly increasing access to health

information.The public has shown interest in these technological

changes, and the evolving health communication and informatics

environment appears to be changing the way individuals and

populations engage in their health and health care.

Although information technology has considerable potential to

accelerate evidenced-based efforts to reduce the cancer burden through

personalized communication about risk, prevention behavior, social

support, and individualized networks of care, questions remain regarding

population engagement with technology to support their health and

health information needs. In this HINTS Brief, we describe trends in

cancer and health information seeking across time and document which

information sources are most used and most trusted by Americans.

Cancer Information Seeking

According to HINTS data collected in 2008, nearly 40% of the U.S.

population (39.3%) has searched for cancer information at some

point.The two most frequently used sources of cancer information

were the Internet (55.3%) and health care providers (24.9%).

What Sources Do Americans Trust? 

A recent HINTS publication by Hesse and colleagues published in

the New England Journal of Medicine examines data across three

administrations of HINTS (2002–2008) to explore the public’s use

of and trust in sources of health information, with a particular focus

on physicians and the Internet.A striking finding from this research

is that in spite of rapid increases in the availability of health

information on the Internet, the public’s trust in online health

information has decreased over time. Meanwhile, trust in physicians

as a source of health information has remained high and actually

increased from 2002 to 2008. Despite the public’s reported

skepticism of online content, health information seeking on the

Internet remains high. Moreover, HINTS data suggest that access to

online health information does not erode trust in physicians and

health care providers. Rather, trust in providers may actually be

increasing because consumers depend on their health care providers

to make sense of health information found online.

HINTS data also show an increase in online communication

between health care providers and their patients. In 2002, just 7% of

the population used e-mail or the Internet to communicate with

their health care provider; however, this number steadily increased

to 9.6% in 2005 and 13.5% in 2008.

Quick Facts

• Almost one-half of the U.S. population has looked for

cancer information.

• Trust in the Internet as a source of health or cancer

information has decreased over time.

• Trust in health care providers as a source of health or

cancer information has increased over time.

• Use of e-mail and the Internet to communicate with

doctors and health care providers is increasing.

Have you ever looked for information about cancer from any source?*

0.13% Don’t know •

0.02% Refused •

39.3% Yes •

60.5% No •

The most recent time you looked for cancer information, where did

you go first?*

0.41% Other •

13.8% Printed materials •

2.9% Interpersonal source •

55.3% Internet •

24.9% Health care provider •

2.5% Information specialist •

Health Information National Trends Survey, 2007 (HINTS, 2007); URL: cancercontrol.cancer.gov/hints; HINTS 2007

database, National Cancer Institute, DCCPS, Behavioral Research Program, Health Communication and

Informatics Research Branch. Data collection January-May, 2008; Public data release February 2009.

*Due to rounding, percentages may not equal 100.

Trends in Cancer Information Seeking 
August 2010

References Used in This HINTS Brief

Hesse BW, Moser RP, Rutten LJ. Surveys of physicians and electronic health

information. N Engl J Med. 2010 Mar 4;362(9):859-60.

Hesse BW, Nelson DE, Kreps GL, Croyle RT,Arora NK, Rimer BK,Viswanath K.

Trust and sources of health information: the impact of the Internet and its

implications for health care providers: findings from the first Health Information

National Trends Survey. Arch Intern Med. 2005 Dec 12-26;165(22):2618-24.

Viswanath K. Science and society: the communications revolution and cancer

control. Nat Rev Cancer. 2005 Oct;5(10):828-35.

For More Information on Cancer

• Call the NCI Cancer Information Service at 1-800-4-CANCER

• Visit http://cancer.gov

• Order NCI publications at https://cissecure.nci.nih.gov/ncipubs/

The National Cancer Institute (NCI) fielded the first Health Information National Trends Survey (HINTS) in 2002 and 2003, surveying

6,369 Americans. Subsequent surveys followed in 2005 (5,586 Americans surveyed) and 2008 (7,674 Americans surveyed). HINTS was

created to monitor changes in the rapidly evolving field of health communication.The survey data can be used to understand how

adults 18 years and older use different communication channels to obtain health information for themselves and their loved ones, and

to create more effective health communication strategies across populations.

HINTS Briefs provide a snapshot of noteworthy research findings.They introduce population-level estimates for specific questions in

the survey and summarize significant research findings that are a result of analyzing how certain demographic characteristics influence

specific outcomes. Many Briefs summarize research findings from recent peer-reviewed journal articles using HINTS data.

The trends in health information seeking observed across the • As highly trusted sources of information, health care providers can

last decade point to interesting challenges and opportunities for employ health information technology to deliver personalized advice

improving population health and realizing the potential of health and to support patient engagement.

information technology. • Health services researchers and behavioral scientists can utilize

• Individuals with access to health care should be encouraged to information technology in their efforts to develop and implement

proactively engage in health management and disease prevention research protocols that support the discovery of more cost-effective

within the health care setting and beyond. systems for care delivery.

• Health information technology can support and empower individuals

by enabling them to own and manage their health information.

About HINTS

http://hints.cancer.gov

Income

Although cancer information seeking is pervasive and increasing across

the population, adults with lower incomes are consistently less likely

than adults with higher incomes to report ever looking for cancer

information from any source.Approximately 40% of adults with

incomes less than $25,000 per year have ever sought cancer

information, while more than 60% of adults with incomes more than

$75,000 per year say they have.Trust in health information sources

follows a similar income pattern, with those making more than $75,000

per year reporting a lot of trust in doctors (75.6%) and the Internet

(20.1%) and those making less than $25,000 per year being less likely

to report a lot of trust in doctors (60.5%) and the Internet (16.5%).

Education 

Adults with higher levels of education are also more likely to report

seeking cancer information and trusting health information from doctors

and the Internet than those with lower levels of education. For example,

64% of college graduates say that they have looked for cancer

information, compared with 23.9% of those with less than a high school

education.While 59.8% of individuals with less than a high school

education report a lot of trust in doctors, 74.8% of college graduates

do. For trust in the Internet as a source of health information, 20.6% of

college graduates report a lot of trust in the Internet compared to

17.3% of those with less than a high school education.

How Can This Inform Your Work?

Use of and Trust in Health Information Sources:

Differences by Income and Education

HINTS 2005 data reveal interesting differences in use of and trust in health information sources by key sociodemographic characteristics.