Quality of Patient-Orientated Internet Information on Watch and Wait for Rectal Cancer

Total mesorectal excision (TsE) for rectal cancer is associated with significant morbidity. The 'Watch and Wait' approach, following a complete clinical response (cCR) to total neoadjuvant therapy (TNT), is increasingly considered as an alternative to surgery. The Internet offers extensive resources but the quality of these resources relating to 'Watch and Wait' is unknown. This study evaluates the availability and quality of online resources on 'Watch and Wait' as an option for patients with rectal cancer.

Using Google, search phrases: 'patient information watch and wait rectal cancer' and 'patient information non-operative management rectal cancer' were employed. The first 50 results of each search were assessed. Relevant sites meeting inclusion criteria were assessed using the DISCERN instrument, which evaluates the quality of published health information on treatment choices.

Of 100 sites reviewed, three were duplicates. Fourteen sites provided dedicated patient-oriented information. Among non-dedicated sites, there were 63 scientific articles, 7 blogs, 6 resources for surgeons, 3 medical news articles, 2 videos, and 2 blocked sites. Of these 14 websites, 5 (35.7%) were updated within the last 2 years; 8 (57.1%) were associated with hospitals and clinics, and 6 (42.9%) with government or non-profit organizations. Most sites detailed the benefits of non-operative management, but 10 (71.4%) omitted uncertainties or risks. Only two (14.3%) were deemed 'high-quality' by DISCERN criteria.

Online patient resources on 'Watch and Wait' for rectal cancer are limited and often of poor quality. High-quality websites should be identified and recommended to patients wishing to seek further information on this topic.