Digitalization in Breast Cancer Care: Health App Use and Patient Needs-A Cross-Sectional Survey

Despite the rapid proliferation of mobile health applications in oncology, real-world uptake, determinants of use, and patient needs among breast cancer patients remain insufficiently described, particularly in the German healthcare context. This study aimed to assess health app use in breast cancer patients and to identify sociodemographic, lifestyle, and psychosocial correlates.

We conducted a non-interventional, cross-sectional, anonymous paper-based survey among adult breast cancer patients receiving outpatient, day-care, or inpatient treatment, or follow-up at a tertiary university hospital (July 2022-January 2023). Descriptive statistics and group comparisons with false discovery rate correction and multivariable logistic regression were used to examine associations between app use and sociodemographic, lifestyle, and psychosocial variables.

A total of 202 patients were included (mean age 56.4 ± 13.8 years). Health app users were significantly younger than non-users (51.7 ± 11.0 vs. 64.7 ± 13.8 years, p < 0.001, Cohen's d = 1.08). Age was the only variable that was independently associated with the use of health apps in the multivariable analysis (adjusted OR 0.43 per 10 years, 95% CI 0.29-0.64). Health app use showed no significant associations with indicators of physical fitness or lifestyle, perceived social support, or emotional burden. Health and fitness apps were the most frequently used app category (77.4%). Physicians were the most frequently consulted source of medical information (77.6%), and only one participant reported having received a digital health application on prescription.

In this breast cancer cohort, health app use was common and age-associated. Given patients' reliance on physicians and the near-absent DiGA prescription rate, age-sensitive implementation strategies and structured clinician guidance are needed to support equitable digital engagement in breast cancer care.