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Purpose <p>Online cancer forums are often assumed to promote misinformation and unsupported treatment claims, including some non-evidence-based complementary and alternative medicine (CAM) approaches. This study examined the relationship between online cancer forum use, attitudes toward complementary and alternative medicine (CAM), and the use of non-evidence-based therapies, with a specific focus on CAM approaches prevalent in German-speaking countries.</p> Methods <p>A cross-sectional anonymous online survey was conducted in June–July 2025 among adult users of the largest German cancer forum, assessing forum use, CAM-related attitudes (defined according to the German S3 guideline checklist, version 1.2), eHealth literacy, psychological distress, and sociodemographic and disease-related variables. Forum use was dichotomized by median split, and data were analyzed using non-parametric tests and multivariable regression models.</p> Results <p>Among 458 participants, high versus low forum use differed by sociodemographic and disease-related factors but was not associated with eHealth literacy or psychological distress. Among CAM users (44.3%, <i>n</i> = 203), CAM use intensity was moderate (median = 2, IQR 1–3) and showed no association with forum use, eHealth literacy, psychological distress, or sociodemographic variables; no independent predictors were identified. CAM-related forum discussions were rated as significantly less trustworthy than discussions on conventional cancer treatments (<i>t</i>(383) = 16.88, <i>p</i> &lt; 0.001), independent of eHealth literacy, psychological distress, or participant role.</p> Conclusion <p>The use of CAM approaches, including both evidence-based supportive interventions and non-evidence-based methods, was not associated with forum exposure, eHealth literacy, or psychological distress. Forum users demonstrated differentiated trust patterns, with consistently lower perceived credibility attributed to CAM-related discussions compared with discussions on conventional cancer treatments.</p> Implications for cancer survivors <p>For cancer survivors, online cancer forums appear to function primarily as contextual support resources rather than drivers of non-evidence-based treatment decisions. Clinicians should therefore address forum use openly and early, focusing on guidance and shared decision-making instead of discouragement.</p>

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Online cancer forums and complementary and alternative medicine in cancer care: effects of ehealth literacy and psychological distress on use and attitudes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月4日

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  • G. Ciarlo,
  • M. Oehlrich,
  • J. Huebner

摘要

Purpose

Online cancer forums are often assumed to promote misinformation and unsupported treatment claims, including some non-evidence-based complementary and alternative medicine (CAM) approaches. This study examined the relationship between online cancer forum use, attitudes toward complementary and alternative medicine (CAM), and the use of non-evidence-based therapies, with a specific focus on CAM approaches prevalent in German-speaking countries.

Methods

A cross-sectional anonymous online survey was conducted in June–July 2025 among adult users of the largest German cancer forum, assessing forum use, CAM-related attitudes (defined according to the German S3 guideline checklist, version 1.2), eHealth literacy, psychological distress, and sociodemographic and disease-related variables. Forum use was dichotomized by median split, and data were analyzed using non-parametric tests and multivariable regression models.

Results

Among 458 participants, high versus low forum use differed by sociodemographic and disease-related factors but was not associated with eHealth literacy or psychological distress. Among CAM users (44.3%, n = 203), CAM use intensity was moderate (median = 2, IQR 1–3) and showed no association with forum use, eHealth literacy, psychological distress, or sociodemographic variables; no independent predictors were identified. CAM-related forum discussions were rated as significantly less trustworthy than discussions on conventional cancer treatments (t(383) = 16.88, p < 0.001), independent of eHealth literacy, psychological distress, or participant role.

Conclusion

The use of CAM approaches, including both evidence-based supportive interventions and non-evidence-based methods, was not associated with forum exposure, eHealth literacy, or psychological distress. Forum users demonstrated differentiated trust patterns, with consistently lower perceived credibility attributed to CAM-related discussions compared with discussions on conventional cancer treatments.

Implications for cancer survivors

For cancer survivors, online cancer forums appear to function primarily as contextual support resources rather than drivers of non-evidence-based treatment decisions. Clinicians should therefore address forum use openly and early, focusing on guidance and shared decision-making instead of discouragement.