Clinical features of American versus non-American gynecologic cancer patients requesting information from a proprietary web-based decision-support program.
OBJECTIVE
As the Internet can potentially substantially reduce geographic barriers to the dissemination of health-related information, it would be interesting to know if non-American women with gynecologic malignancies accessing United States (US)-based cancer Web sites differ from American patients with the same illness.


METHODS
Aggregate data from individuals providing personal clinical information into one of four proprietary gynecologic cancer (cervix, endometrial, newly diagnosed and recurrent ovarian cancers) decision-support programs (NexProfiler Treatment Option Tools for Cancer; NexCura Inc., Seattle WA, USA) currently embedded within approximately 100 established cancer-related Web sites were examined for differences between American versus non-American patient populations.


RESULTS
In this analysis, which included >15,000 patients, American and non-American gynecologic cancer patients were remarkably similar in most clinical characteristics, including age, stage of disease at presentation, overall health, and desire to receive information regarding clinical trials. Notable differences included features suggestive of a more aggressive surgical philosophy in the US (e.g., higher percentage of American recurrent ovarian cancer patients reported they had undergone a secondary surgical procedure; greater use of radiotherapy in non-American cervical cancer patients).


CONCLUSIONS
Despite differences in geographic location and health care delivery systems, American and non-American patients with gynecologic malignancies and with access to Internet-based cancer information exhibit few, but notable, differences in self-reported clinical characteristics.
University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA. mmarkman@mdanderson.org
Maurie
M
Markman
Margaret
M
Markman
Judith
J
Petersen
Angela
A
Belland
D000328:Adult; D001315:Australia; D002170:Canada; D003657:Decision Making; D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data*; D016889:Endometrial Neoplasms / Q000628:therapy; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D005858:Germany; D006801:Humans; D007194:India; D033181:Information Dissemination; D020407:Internet; D008800:Mexico; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000628:therapy; D011878:Radiotherapy / Q000706:statistics & numerical data; D024162:Second-Look Surgery / Q000706:statistics & numerical data; D006113:United Kingdom; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000628:therapy