1. Rose Clark-Hitt 1 Marleah Dean 2 Sandi W. Smith 1 Samantha Nazione 1 Charles Atkin 1 Pamela Whitten 1 1 Michigan State University, 2 University of New Mexico

2. Background: Breast Cancer Prevalence & Health Information on Internet Breast Cancer Prevalence New cases diagnosed per year (over 250,000) Deaths each year from breast cancer (over 40,000) Internet and Health Over 80% of Americans report using the internet to visit health websites (Fox, 2006) 41% of BC patients use internet for information (Fogel, 2002)

3. Background: Prior Content Analysis Research Breast cancer news media content analyses Newspapers TV news Breast cancer website content analysis Content & website quality

4. Background: Purpose of Present Content Analysis Goal to provide comprehensive review of breast cancer information on the web, extending prior content analyses Breast Cancer and the Environment Research Center grant Goal to learn about environmental factors that may increase risks for breast cancer and to communicate to public

5. Background Examined following categories of content: 1. Awareness 2. Environmental risks 3. Prevention 4. Detection 5. Treatment 6. Social Support 7. Survivorship

6. Method Sample Google, Yahoo, & MSN Unit of analysis Individual web page N= 415 Ordinal coding Main focus of web page (3) Secondary focus of web page(2) Mention only on web page(1) Absent on web page (0) 2 coders established reliability

7. Results for Overall Categories Content AreaMajor EmphasisMinor EmphasisNo Content Awareness16%36%47% Environmental Risks 13%36%50% Prevention16%45%39% Detection9%43%48% Treatment22%41%38% Social Support2%30%67% Survivorship4%34%63%

8. Results Awareness Environmental Risks Most common awareness topic was information about breast cancer such as types and stages (about 39%) About 4% of pages had prevalence in terms of number of cases The most prevalent topic with a major emphasis was exposure to chemicals (5%) For minor content, greatest number of web pages mentioned avoiding unhealthy diet (10.7%) and the role of hormones (10.5%).

9. Results Prevention Detection Very little content on parental prevention behaviors to help daughters (1.2% had minor emphasis) About 10% had minor emphasis and 5% major emphasis on individual prevention About a third contained information about symptoms Mammograms appeared in about 16% BSE, X-ray, and MRI in about 5%

10. Results Treatment Survivorship & Social Support Chemotherapy most common treatment topic (33%), followed by surgical procedures (23%), radiation (20%), and holistic medicine (5%) Survivorship most common content related to side effects of treatment (about 5%) For social support, the most common content was network support (about 13%)

11. Implications & Conclusions Most common topics: treatment & prevention Prevention: similar findings with prior work showing most prevention messages are directed at self, not helping others prevent breast cancer Little coverage of parental prevention Environmental risks: hormones, avoiding particular chemicals, foods Limitations: small sample of availability on internet; search terms, & patterns of use

12. Implications & Conclusions Provides insight on content women are exposed to when searching popular websites May provide insight for website design to better serve women Future directions Agenda setting and how content on web pages influences perceptions of what topics are important regarding breast cancer

13. Websites Cornell University Program on Breast Cancer and Environmental Risk Factors envirocancer.cornell.edu Breast Cancer and the Environment Research Centers bcerc.org/home.htm BreastCancer.Orgbreastcancer.org Breast Cancer Fundbreastcancerfund.org National Breast Cancer Coalitionstopbreastcancer.org National Institute of Environmental and Health Sciences niehs.nih.gov/research/supported/centers/breast- cancer/index.cfm Yahoo Healthhealth.yahoo.com/breastcancer-overview/breast-cancer- topic-overview/healthwise--tv3617.html Mayo Clinicmayoclinic.com/health/breast-cancer/DS00328 Oncolink oncolink.org/types/article.cfm?c=3&s=5&ss=33&id=8320 The National Cancer Institutecancer.gov/cancerinfo/types/breast The National Cancer Institute cancer.gov/cancerinfo/pdqratmentbreas/helathprofessional/allpages /print Wikpediaen.wikipedia.org/wiki/Breast_cancer BreastCancer.netbreastcancernet.org American Cancer Societycancer.org/docroot/CRI/CRI_2x.asp?sitearea=LRN&dt=5