An Analysis of Characteristics and Content of Highly Used Books for the General Population in the Cancer Space on Amazon.com.

e24034 Background: Cancer patients and supporters frequently turn to written resources for assistance and empowerment in decision-making. Previous work has analyzed misinformation available on search and social media platforms; however, little attention has been paid to amazon.com (AMZ) despite 37% of cancer patients seeking information from books. Previous work also suggests there is a preponderance of vaccine-hesitant books on AMZ. Here, we report the first analysis of the characteristics and content of books, excluding medical textbooks, in the cancer space. Methods: On 11/25/20, the top 100 books were pulled from the “Best Sellers in Cancer” (BS) page on AMZ. Queries were also performed using keywords “cancer treatment” (CT), and “natural cancer treatment” (NCT), filtering for books. Non-sponsored results from the first 5 pages per search were pulled. 2 coders were trained to manually collect variables on genre, advice, terminology (TN) in the description, author, and publisher; disagreement was settled by a third coder. Books were excluded if they were not in English, duplicates within the same query, did not focus on human cancer, or were medical textbooks. Chi square testing was used to compare results of CT v. NCT. Analysis was performed using R software. Results: 56, 60, and 70 books were included for BS, CT, and NCT, respectively. For BS, 15 (26.8%) were memoirs, 12 (21.4%) dietary guides, 11 (19.6%) treatment guides, 6 (10.7%) self-help, and 4 (7.1%) cookbooks. 16 (28.6%) focused on one tumor subtype; breast was the most common (9, 56.3%). Many appeared to offer non data-driven advice (Table). Many BS books employed “war” TN (ex: fight, battle), “hype” TN (ex: game-changing), spiritual TN (ex: faith, God, prayer), and CAM TN (ex: supplement, herb) (Table). Many also insinuated offering a cure, or a novel therapy (Table). Compared with CT books, NCT books were more likely to offer non-data driven advice and be published independently, and less likely to have an MD/DO author (Table). Conclusions: Nonscientific advice is present in many non-medical text cancer books available on AMZ, including BS books. Patients seeking information on AMZ about NCT are likely to find books offering non-data driven advice or that insinuate a cure or new/novel information. Future work should investigate opportunities to regulate such content or to direct patients towards high-quality resources on platforms like AMZ.[Table: see text]