Paging Dr. Google: Characterizing Direct-to-Consumer Digital Advertisements From Oncology Treatment Centers

This study aims to examine the characteristics and accreditations of medical centers with the highest utilization of direct-to-consumer (DTC) marketing based on Google search advertisements.  Methods: A total of 817 paid advertisements from 360 simulated Google searches from the 30 most populous U.S. cities were analyzed. They were categorized into National Cancer Institute (NCI)-designated, Commission on Cancer (CoC) accredited, non-CoC accredited, and non-traditional treatment centers and analyzed based on city, region, and search term.  Results: Of the cancer treatment center advertisements analyzed, 51.2% were for NCI centers, 12.2% for CoC accredited centers, 26.9% for non-CoC accredited centers, and 9.7% for non-traditional centers. There was significant geographic variation, with the highest percentage of NCI advertisements appearing for the search phrase "best cancer doctor" (74.4%). The majority of NCI centers had no advertisements (59.2%), while two of the centers monopolized the NCI advertisements (80.2%). Non-traditional treatment centers showed significant geographic variation, representing 0-38% of search results.  Conclusion: The study reveals a significant presence of NCI-designated cancer centers in the digital DTC marketing space, with substantial regional variations and a disproportionate number of advertisements from a minority of cancer centers.