Readability of online skin cancer resources: a review of content from major dermatology societies

Readability of online dermatologic content related to skin cancer and Mohs micrographic surgery is essential for effective patient education. This study assessed the readability of such materials on the websites of three major dermatology societies including the American Academy of Dermatology (AAD), American College of Mohs Surgery (ACMS), and American Society for Dermatologic Surgery (ASDS). Five standard readability formulas were used, including Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease (FRE), Gunning Fog Index (GFI), Coleman-Liau Index (CLI), and Simple Measure of Gobbledygook (SMOG). Across all analyses, SMOG and FKGL scores exceeded the recommended fifth-grade reading level for patient education materials. Results showed significant variation in readability by cancer type, with melanoma-related content being more difficult to read than materials on basal cell carcinoma (p = 0.003 [FKGL], 0.002 [FRE], 0.001 [CLI]) or squamous cell carcinoma (p = 0.033 [FKGL], 0.041 [FRE], 0.001 [CLI]). Readability also differed by source, with AAD and ACMS content scoring higher in complexity than ASDS (AAD vs. ASDS: p < 0.001 [FRE], < 0.001 [CLI]; ACMS vs. ASDS: p < 0.001 [FRE], < 0.001 [CLI]). However, no significant differences were found across subtopics (overview, diagnosis, Mohs, treatment), suggesting that writing style was consistent within each website. These findings highlight a need to simplify and standardize online dermatologic resources to ensure they are accessible to patients with varying levels of health literacy. The limited availability of Spanish-language materials highlights an additional barrier to accessibility. Although simplifying online content is important, it must be balanced with preserving essential clinical nuance. Overall, these findings underscore the need to improve and standardize online dermatologic resources to enhance accessibility without compromising accuracy.