African American and Spanish-speaking patients with cancer are less likely to access electronic portals than are Caucasians, according to a research letter published in JAMA Oncology.1 This trend may, furthermore, exacerbate ethnicity-associated health disparities.

While online patient portals are becoming ubiquitous in clinical oncology, whether and how patients with cancer interact with online data is not well-studied. Whether any particular groups of patients with cancer are less likely to interact with patient portals was previously unknown.

For this study, researchers reviewed data from 19,434 patients treated at the Harold C. Simmons Comprehensive Cancer Center who enrolled in the online portal system between 2007 and 2016. The median patient age was 64 years, 50% were male, and 75% were Caucasian. Uninsured patients were not included.

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African Americans were half as likely as others to view any online results (odds ratio, 0.50). Spanish speakers were the least likely to view results, with an odds ratio of 0.37.

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There was, furthermore, a decrease from 2012 to 2015 in the overall rate of result-viewing (61% vs 38%, respectively). This finding, according to the authors, may be explained by information overload.

The authors concluded that “research to explain and address these trends is needed. That portal use may exacerbate rather than ameliorate health care disparities highlights the importance of critically evaluating this technology to improve patient engagement and quality of care.”


  1. Pho K, Lu R, Gates S, Xie Y, Craddock Lee SJ, Gerber DE. Characteristics of patients using patient portals in oncology. JAMA Oncol. 2018 Jan 25. doi: 10.1001/jamaoncol.2017.5257 [Epub ahead of print]