title: Readability Comparison of Pro- and Anti-Cancer Screening Online Messages in Japan
abstract: Background: Cancer screening rates are lower in Japan than those in western countries. Health professionals publish procancer
  screening messages on the internet to encourage audiences to undergo cancer screening. However, the information
  provided is often difficult to read for lay persons. Further, anti-cancer screening activists warn against cancer screening
  with messages on the Internet. We aimed to assess and compare the readability of pro- and anti-cancer screening online
  messages in Japan using a measure of readability. Methods: We conducted web searches at the beginning of September
  2016 using two major Japanese search engines (Google.jp and Yahoo!.jp). The included websites were classified as
  “anti”, “pro”, or “neutral” depending on the claims, and “health professional” or “non-health professional” depending
  on the writers. Readability was determined using a validated measure of Japanese readability. Statistical analysis was
  conducted using two-way ANOVA. Results: In the total 159 websites analyzed, anti-cancer screening online messages
  were generally easier to read than pro-cancer screening online messages, Messages written by health professionals were
  more difficult to read than those written by non-health professionals. Claim × writer interaction was not significant.
  Conclusion: When health professionals prepare pro-cancer screening materials for publication online, we recommend
  they check for readability using readability assessment tools and improve text for easy comprehension when necessary.
authors.affiliation: Department of Health Communication, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Email: okuhara-ctr@umin.ac.jp
authors.forename: Tsuyoshi
authors.initials: Ts
authors.lastname: Okuhara
authors.forename: Hirono
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Masahumi
authors.initials: M
authors.lastname: Okada
authors.forename: Mio
authors.initials: M
authors.lastname: Kato
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kiuchi
keywords: Cancer screening; readability; anti-cancer screening online messages; pro-cancer screening online messages