The Internet has become an important source of overall health information and seems to be the second common source of information used by patients in the process of decision-making before breast surgery. The goal of this study was to monitor Romanian breast cancer websites and their quality over a period of 5 years. We evaluated a sample of 20 websites selected from Google's first search results pages using specific rating scores for e-health quality, completeness, accuracy, and potential risk, in 2011 and 2016, respectively. Only 15 (75%) of the websites in the 2011 sample were accessible in 2016 and only two (10%) retained real-life visibility (Google PageRank < 20). The mean quality scores at baseline (2011) and follow-up (2016), respectively, were as follows: e-health quality 3.80 vs. 4.05; completeness 4.23 vs. 5.43; accuracy 5.74 vs. 6.35; and potential risk score 7.60 vs. 7.30. All quality scores were low or, at best, modest and did not improve significantly over the 5-year period. The results of the study draw attention to the need for programs aiming to improve the ability of breast cancer patients to screen the online health resources and to better regulate the medical Internet to safeguard the best interest of health information seekers.
Keywords: Breast cancer; Consumer health information; Health literacy; Internet.