1. ¹Division of Radiotherapy, University Hospital of Freiburg, Hugstetter Strasse 55, D-79106 Freiburg, Germany
2. ²Institute of Medical Biometry and Medical Informatics, University of Freiburg, Department of Medical Informatics, Stefan-Meier-Strasse 26, D-79104 Freiburg, Germany
3. ³Institute of Medical Biometry and Medical Informatics, Department of Medical Biometry and Statistics, University of Freiburg, Stefan-Meier-Strasse 26, D-79104 Freiburg, Germany
4. ⁴Department of Obstetrics and Gynecology, University Hospital of Freiburg, Hugstetter Strasse 55, D-79106 Freiburg, Germany
5. ⁵Department of Radiotherapy, Deaconess Hospital, Am Mutterhaus 1, D-74523 Schwäbisch-Hall, Germany

Correspondence: Dr C Weissenberger, E-mail: weissenb@mst1.ukl.uni-freiburg.de

⁶These two authors contributed equally to this work

Received 29 March 2004; Revised 2 July 2004; Accepted 9 August 2004; Published online 5 October 2004.

Abstract

Individual belief and knowledge about cancer were shown to influence coping and compliance of patients. Supposing that the Internet information both has impact on patients and reflects patients' information needs, breast cancer web sites in English and German language were evaluated to assess the information quality and were compared with each other to identify intercultural differences. Search engines returned 10 616 hits related to breast cancer. Of these, 4590 relevant hits were analysed. In all, 1888 web pages belonged to 132 English-language web sites and 2702 to 65 German-language web sites. Results showed that palliative therapy (4.5 vs 16.7%; P=0.004), alternative medicine (18.2 vs 46.2%; P<0.001), and disease-related information (prognosis, cancer aftercare, self-help groups, and epidemiology) were significantly more often found on German-language web sites. Therapy-related information (including the side effects of therapy and new studies) was significantly more often given by English-language web sites: for example, details about surgery, chemotherapy, radiotherapy, hormone therapy, immune therapy, and stem cell transplantation. In conclusion, our results have implications for patient education by physicians and may help to improve patient support by tailoring information, considering the weak points in information provision by web sites and intercultural differences in patient needs.