Most Online Lung Cancer Screening Materials Fall Short of National Literacy Recommendations

Leesburg, VA, July 16, 2018—Almost 98 percent of online patient education materials outlining the benefits and risks of lung cancer screenings are written at a level beyond the general patient population's ability to comprehend, and this may contribute to a knowledge gap that is inhibiting patients from improving their health literacy, according to an article published in the July 2018 issue of the American Journal of Roentgenology (AJR).

The study authors, led by David Richard Hansberry of Thomas Jefferson University Hospitals, found that about 2.5 percent of online lung cancer screening materials adhere to the recommendations of the National Institutes of Health and the American Medical Association. These guidelines recommend that patient education materials are written at a third-grade to seventh-grade level.

For their study, researchers searched online for the terms “pulmonary nodule,” “radiation,” “low-dose CT” and “lung cancer screening,” and the first 20 online resources for each term were downloaded, converted into plain text, and analyzed using 10 well-established readability scales. If the websites were not written specifically for patients, they were excluded.

The 80 articles were written at a 12.6 ± 2.7 (mean ± SD) grade level, with grade levels ranging from 4.0 to 19.0. Of the 80 articles, 62.5% required a high school education to comprehend, and 22.6% required a college degree or higher (≥ 16th grade) to comprehend.

“It is reasonable to suspect that lowering the reading level of education materials may reduce the quality of the information being conveyed to the reader. However, using simpler sentence structure, less complex words, and words with fewer characters can convey the same information in a more easily understood text,” the authors stated.

“Higher health literacy among patients can improve the rates of lung cancer screening and potentially improve outcomes in patients with lung cancer,” the study noted.


Founded in 1900, ARRS is the first and oldest radiology society in the United States, and is an international forum for progress in radiology. The Society's mission is to improve health through a community committed to advancing knowledge and skills in radiology. ARRS achieves its mission through an annual scientific and educational meeting, publication of the American Journal of Roentgenology (AJR) and InPractice magazine, topical symposia and webinars, and print and online educational materials. ARRS is located in Leesburg, VA.