The saturation of the Internet into daily life in many parts of the world has characterised the early part of the 21st century. As a communication medium, the Internet has huge potential to increase health-related knowledge and behaviours among the general population to ultimately help prevent chronic diseases such as cancer. However, the actual effectiveness of the Internet in improving cancer-preventive behaviours among older adults, who are among the most at risk for cancer, is unclear. Importantly, there is unequal access to and use of the Internet in the population. In the United Kingdom, women, older adults, and those with low income are less likely to use the Internet; this phenomenon is called the ‘digital divide’. If using the Internet leads to participation in healthy behaviours and ultimately lower chances of cancer, then inequalities in access to online health information may increase inequalities in cancer outcomes.
Our study examined whether Internet use is associated with cancer-preventive behaviours and whether a ‘digital divide’ exists. To do this we used data from 5,943 participants in the English Longitudinal Study of Ageing: a nationally-representative study of English adults aged 50 years and older. The study participants responded to questions about Internet and email use, self-reported colorectal and breast cancer screening, physical activity, eating habits, physical and cognitive abilities, and demographics every two years from 2002 to 2011.
We found that 41.4% of older English adults reported not using the Internet at all between 2002 and 2011, while 38.3% used the Internet intermittently and 20.3% used the Internet continuously during this time period. Men and women who consistently used the Internet were two times more likely to participate in colorectal cancer screening than those who never used the Internet. They were also 50% more likely to take part in regular physical activity, 24% more likely to eat at least five daily servings of fruit and vegetables, and 44% less likely to be current smokers.
In short, we found that Internet plays a positive role in promoting healthy cancer-preventive behaviours. Our research also confirmed that a ‘digital divide’ exists: Internet use in this study was higher in younger, male, white, wealthier, and more educated adults and lower in older, female, non-white, poorer, and less well-educated adults. Age is a particularly important factor in the ‘digital divide’, as over 40% of all adults aged 50 and up reported never using the Internet. Providing appropriate support and opportunities for Internet access among older adults may be a key first step to improving health among the ageing population. More generally, increasing Internet access among groups with low rates of Internet usage may have substantial public health benefits. Policymakers must understand this potential for ‘digital divides’ to influence inequalities in cancer outcomes – whether for worse, or, for better if targeted efforts are made to increase Internet access and literacy among vulnerable groups.
Office for National Statistics. Internet access quarterly update, 2013 Q1. 2013 [cited 25 October 2013]. Available from: http://www.ons.gov.uk/ons/rel/rdit2/internet-access-quarterly-update/2013-q1/stb-ia-q1-2013.html
Viswanath K, Nagler R, Bigman-Galimore C, McCauley MP, Jung M, Ramanadhan S. The communications revolution and health inequities in the 21st century: implications for cancer control. Cancer Epidemiol Biomarkers Prev 2012;21:1701-8.
Xavier AJ, d’Orsi E, Wardle J, Demakakos P, Smith SG, von Wagner C. Internet use and cancer-preventive behaviours in older adults: findings from a longitudinal cohort study. Cancer Epidemiol Biomarkers Prev 2013 (in press).