Ninety million adults in the U.S. do not read at levels higher than high school, therefore, the NIH (National Institutes of Health) is suggesting that patient information material should be written on a 4th-6th grade level, according to a study conducted by researchers at Loyola University Medical Center and published in the Journal of Urology.

The researchers have discovered that a mere 4.8% of informational websites regarding prostate cancer are written in a level lower than high school – the average level the researchers found on the websites was 12th grade.

Gopal Gupta, MD, senior author of the study, said: “This is problematic for one-third of Americans who seek to further educate themselves using online resources.”

During their study, the team found 62 online sites by typing in “prostate cancer”, “prostate cancer treatment”, or “prostatectomy” in either Google, Yahoo, or Bing search engines. To test the level of the reading material on each site, the researchers used word processing software, which read the first 300 words written on every site they visited.

The test utilized by the experts was called the Flesch-Kindcaid test, which works by evaluating the level of reading, as well as the Flesch reading ease test, which scores the reading with a grade of 0 to 100. The tests include data on how many words, sentences and syllables are used.

The report stated that 63% of the websites were written in a level of 12th grade or higher, and the average Flesch reading ease score was 38.1 out of 100, which the authors said is reasonably advanced. Websites with scores between 90 and 100 would be understood by someone around the age of 11, whereas a score between 60 and 70 would be appropriate for 13 to 15 year olds, and below 30 would be a level for college graduates.

Web pages with scores that were easiest were News-Medical Net which was found to have an 8th grade level, Consumer at a level of 8.9, Family with a level of 8.95, UPMC Cancer Centers at 9.2 and NIH Pubmed Health with a level of 9.8. Gupta continued:

“It was discouraging to find that only 4.8 percent of these sites had information written for those below a high school reading leavel. No sites in our study were written at the level recommended by the NIH (4-6th grade). Given that nearly one-third of the U.S population reads below high school level, this raises the concern that many patients will have difficulty comprehending online information about prostate cancer treatment options.”

Prostate cancer is described by the authors as one of the most difficult subjects for patients to understand because of all of the options involved, including surgery, radiation, active surveillance and radiation beam therapy. Every decision the patient makes after diagnosis needs to be weighed carefully in order to make the right choice of treatment methods, etc.

The experts concluded:

“Clinicians should be aware that some of their patients may not be able to read online information and should consciously guide patients with low literacy to not only high-quality web sites, but also sites that are easy-to-read, to prevent confusion and anxiety after being diagnosed with prostate cancer.”

Written by Christine Kearney