Doctors Remain Trusted Sources for Cancer Info in Post-Pandemic Era

While trust in doctors as a source of information about cancer remained high during and after the COVID-19 pandemic, trust in government health agencies decreased, a cross-sectional study showed.

Data from the National Cancer Institute’s Health Information National Trends Survey (HINTS) showed that the prevalence of trust in physicians as a source of cancer information was 95.7% in the prepandemic period (January 2018 through February 2020), with that level of trust remaining unchanged through 2024, reported Todd Burus, PhD, of the University of Kentucky in Lexington, and colleagues.

However, trust in government health agencies as a source of such information — 75.9% before the pandemic — was lower in the late-pandemic (71.3%; adjusted prevalence ratio [APR] 0.93, 95% CI 0.90-0.97) and post-pandemic periods (71.7%; APR 0.94, 95% CI 0.90-0.97), they noted in a research letter in JAMA Network Open.

There was also lower trust in charitable organizations during the late-pandemic period (51.8% to 47.9%; APR 0.92, 95% CI 0.85-0.99), and lower trust in family or friends during the post-pandemic period (58.2% to 52.6%; APR 0.91, 95% CI 0.85-0.97).

“During the COVID-19 pandemic, trust in traditional health authorities in the U.S. was tested amid rapidly changing guidance, competing narratives, and widespread misinformation,” Burus and colleagues pointed out.

Low trust in cancer information from physicians and healthcare systems has been tied to poor adherence or nonadherence to cancer screening guidelines, while higher levels of trust have been linked to a greater uptake of genetic testing and cancer treatment concordance, they explained.

“The patterns we observed align with recent reports that cancer-related information and behavior may be increasingly shaped by nontraditional messengers,” they wrote. “Coordinated cancer communication efforts may help reinforce evidence-based information through trusted clinical, public health, and community sources.”

In an accompanying commentary, Skyler B. Johnson, MD, of the University of Utah School of Medicine in Salt Lake City, noted that these findings “suggest that physicians remain a remarkably consistent source of trust for patients with cancer, even in a rapidly changing information environment. This level of trust is important because by the time patients arrive for an initial oncology consultation, many have already begun searching for answers across a wide range of information sources that vary from evidence based to unreliable.”

“Increasingly, part of the oncologist’s role is helping patients evaluate competing claims while also discussing prognosis and treatment options,” Johnson added. “Effective communication, therefore, requires more than correcting misinformation. It involves understanding why particular claims resonate, acknowledging uncertainty when it exists and helping patients integrate new evidence without dismissing the experiences that shaped their beliefs.”

For this study, Burus and colleagues included data from four survey cycles that assessed trust in cancer information sources: HINTS 5 Cycle 2 (2018), HINTS 5 Cycle 4 (2020), HINTS 6 (2022), and HINTS 7 (2024). Respondents were classified into prepandemic, early-pandemic, late-pandemic, or post-pandemic groups based on survey completion date.

Among respondents, 17,252 had complete data and were included in the analytic sample (mean age 47.9 years, 51% female).

Across periods, 14.8% to 18.5% of respondents reported Hispanic ethnicity, 4.8% to 5.7% reported Asian race, 9.7% to 11.9% reported Black race, and 61.7% to 67% reported white race. In addition, 87% to 88.7% of respondents lived in metropolitan counties, and 7.7% to 9.9% reported a previous cancer diagnosis.

In subgroup analyses, white respondents reported lower trust in government health agencies, from 75.4% in the prepandemic period to 70.2% in the late-pandemic period and 68.7% in the post-pandemic period.

Similar reductions in trust in government health agencies were observed across the same periods among men (75.3% to 69.2% and 69.7%, respectively), adults ages 18 to 34 years (82.3% to 71.2% and 72.6%), metropolitan residents (76.4% to 72.2% and 72.7%), and respondents with no cancer history (76.4% to 71.4% and 72%).

Aside from white respondents, only nonmetropolitan residents showed decreased trust in physicians, from 97.8% in the prepandemic period to 93.2% in the late-pandemic period and 92.9% in the post-pandemic period.

Burus and team acknowledged that the study was limited by potential biases from self-reports, nonresponse, or analytic choices.