지난호
ISSN : 1226-072X
중장년층은 어떻게 암 정보를 얻는가: 암 정보 획득 방식에 따른 정보 획득 동기 유형과 인지적 결과 차이 분석
Seeking vs Scanning: Understanding Middle-Aged South Koreans Approach to Acquiring Cancer Information
An, Seohyun1; Lee, Gunho1*
보건사회연구, Vol.46, No.1, pp.455-478, March 2026
https://doi.org/10.15709/hswr.2026.46.1.455
알기 쉬운 요약
- 이 연구는 왜 했을까?
- 우리는 미디어가 사람들의 암 인식에 어떤 영향을 주는지 알아보고자 했다. 특히 사람들이 암을 얼마나 중요하게 여기고 어떻게 이해하는지, 그 과정에서 미디어는 어떤 역할을 하는지 살펴봤다.
- 새롭게 밝혀진 내용은?
- 적극적으로 암 정보를 찾는 사람은 암 지식 수준이 높았고, 우연히 암 정보를 접한 사람은 암 이슈를 더 중요하게 인식했다. 또 정보 획득 방식에 따라 동기와 주로 이용하는 미디어 유형도 달랐다.
- 앞으로 무엇을 해야 하나?
- 암은 많은 이들의 생명과 직결되며 아직 완전히 극복되지 않은 질병이므로 관련 정보에 대한 사람들의 관심과 반응이 크다. 한편 암 정보는 건강 정보 중에서도 영향력이 크기 때문에 정확한 내용을 전달하는 것이 매우 중요하다. 따라서 “암 예방”이나 “항암 효과” 같은 메시지는 쉽게 사람들에게 영향을 미칠 수 있으며, 부정확한 정보도 빠르게 확산될 수 있다. 앞으로는 사람들이 암 정보를 어떻게 받아들이는지 더욱 깊이 이해하고, 개인 특성에 맞는 효과적인 정보 제공 방안을 마련해야 한다.
Abstract
In order to understand middle-aged Koreans’ characteristics of acquiring cancer information, this study explored which of eight types of motivations significantly influenced different methods of cancer information acquisition—specifically seeking and scanning. The study also examined how these motivations and acquisition methods affected cognitive outcomes, including cancer knowledge and perceived importance of cancer issues. Participants were adults in their 40s, 50s, and 60s—the primary targets of government cancer-prevention programs. Responses were collected from 738 participants, among whom 723 were included in the analysis. Multiple linear and hierarchical regression analysis was conducted to assess the relationship between motivations and outcomes of seeking and scanning. Seeking was primarily driven by topical interest (’topical’), the desire for high-quality background knowledge (‘intellectual’), and situation-related informational needs (‘situational’). Scanning was primarily motivated by the desire to monitor information for the betterment of society (‘surveillant’). Seeking via search engines was positively associated with cancer knowledge for both men and women, while scanning via social media was positively related to perceived importance of cancer issues. Overall, these findings suggest media strategies for cancer prevention that foster cognitive engagement with cancer issues and promote adequate levels of cancer knowledge.
초록
본 연구의 목적은 중장년층의 미디어 기반 암 정보 획득 행위 특성을 파악하는 데 있다. 정보 획득의 방식을 능동적 방식인 정보 탐색(information seeking)과 수동 적 방식인 정보 노출(information scanning) 두 가지로 구분해, 방식의 유형에 따른 정보 획득 원인(동기)과 결과의 차이를 확인했다. 암 정보 획득에 영향을 미치는 원인으로는 의제설정 이론의 정향욕구 8가지 유형이 활용됐으며, 정보 획득에 따른 인지적 결과로는 암 지식 수준과 암 이슈에 대한 인지적 중요성을 분석했다. 본 연구 의 참여자는 40대, 50대, 60대 중장년층으로, 정부의 암 예방 정책의 주요 대상이다. 738명의 응답 중 불성실한 응답을 제외한 723명의 자료가 최종 분석에 사용되었으 며, 분석에는 다중 회귀분석법과 위계적 회귀분석법이 활용되었다. 그 결과, 암 정보 탐색은 주로 ‘평소 암 주제에 관심을 가지고 있어 암 정보를 얻으려는 동기(화제적 동기)’, ‘배경지식 형성을 위해 고품질의 암 정보를 얻으려는 동기(지적 동기)’, ‘현재 자신이 처한 상황에 의해 암 정보를 얻으려는 동기(상황적 동기)’에 의해 행해졌다. 반면 암 정보 노출은 주로 ‘사회적 감시 및 공익적 모니터링을 위해 암 정보를 얻으려 는 동기(사회감시적 동기)’와 관련이 깊은 것으로 나타났다. 또한 검색 엔진을 통한 정보 탐색은 암 지식 형성에, 소셜미디어를 통한 정보 노출은 암 이슈에 대한 인지적 중요성 형성에 긍정적인 영향을 미쳤다. 이러한 결과는 중장년층의 암 인식 제고 및 암 예방 행위 실천을 위한 미디어 활용 전략을 마련하는 데 중요한 기초 자료가 될 것이다.
Ⅰ. Introduction
With the advent of the Internet, not only have sources of information diversified, but the amount of information provided by the sources has increased dramatically (Jia et al., 2021). Due to this over-saturated media landscape, members of the public cannot possibly pay attention to every piece of media information; depending on their needs, they exert lower or higher effort to find information (Viswanath, 2005).
Traditionally, there was considered to be only one method of acquiring information, which was active and deliberate and required high effort. This was referred to as information seeking. However, in the current environment where users can incidentally come across information while using media, it has been suggested that a more passive and less purposeful way of acquiring information be distinguished from information seeking (Niederdeppe et al., 2007). This newer method is referred to as information scanning.
Information scanning refers to encountering information incidentally while using media, particularly on social media, such as when scrolling through a ‘feed’ or watching ‘short-form’ videos1). Scanning requires less effort compared to seeking and is often made up of an endless chain of short, fragmentary, repeated exposures, which can nonetheless build awareness and prime health concerns in ways that shape subsequent engagement, especially when the information feels personally relevant (e.g. Link, 2025; Hornik et al., 2013; Lewis et al., 2022). Because these encounters are frequent and embedded in feed-based environments, information can spread quickly through recommendations, sharing, and the algorithm, even when the information is unverified or misleading. Given this media environment’s potential to accelerate the spread of both accurate and misleading content, especially on social media, a closer examination of how users engage in information scanning is essential (Lee et al., 2022). Moreover, by understanding the overall process by which users seek and scan cancer-related information, we can gain insight into the mechanisms that drive the widespread dissemination of cancer misinformation.
Cancer misinformation in South Korea has been a recurring problem in online spaces for years, typically involving unfounded claims about treatment efficacy and tending to spread through online communities of cancer patients (MFDS, 2014). A prominent case of this spread of misinformation occurred in 2019: the fenbendazole scandal. In this case, a YouTube video falsely claimed that a veterinary deworming drug could cure cancer (Yoon et al., 2022). The claim rapidly went viral as patients shared personal testimonials on social media, resulting in nationwide confusion and a surge in demand for the drug, even after medical experts refuted its efficacy (Kim et al., 2022; MOHW, 2021). Considering the speed and scale of which the misinformation spread, as well as the nature of the platforms through which it was circulated—primarily through social media—it is difficult to ignore the possibility of information scanning via incidental exposure as a key method of its dissemination. Therefore, to explore these underlying dynamics, this study examines differences in users’ motivations for seeking versus scanning cancer information and how these distinct methods of information acquisition influence their cognition.
Through the division of information acquisition behaviors into seeking and scanning, this study aims to explore users’ primary motivations for each method—which has remained underexplored in the existing literature. One previous study addressed four types of motivation for seeking and scanning health information on Facebook: knowledge fulfillment, entertainment, sociability, and instrumentality (Zheng, 2014). However, these motivations were derived from a grounded theory analysis of interviews with a relatively small sample of 32 young adults, which likely limited the range and variety of motivational categories that could emerge. Moreover, the motivation for seeking and the motivation for scanning found in her study could not be compared because her aim was not to conceptualize the distinct motivations of seeking and scanning, but to extract the predominant motivations of users by classification based on their combination of levels of seeking and scanning.
To better understand the specific motivations based on the method of acquiring cancer information, this study adopts the concept of Need for Orientation (NFO) from agenda-setting theory, a well-established framework in mass communication studies (Weaver, 1980). NFO refers to an individual’s desire or need to seek out information in order to make sense of complex or uncertain situations (An & Lee, 2019). In today’s media environment—where information is abundant and easily accessible—NFO is particularly useful for identifying which particular drives people to actively or passively acquire certain types of information. By applying this concept, the study aims to explain why some users feel a stronger urge than others to seek or scan cancer-related content.
In particular, this study utilized a recent iteration of NFO introduced by An and Lee (2024), which provides a more detailed analysis of participants’ type of motivation for acquiring information through its classification system. This concept of NFO consists of eight sub-dimensions equally divided into the objective (needs fulfilled through gaining objective information) and subjective (needs fulfilled through subjective responses to information) dimensions: ‘topical’, ‘intellectual’, ‘situational’, and ‘surveillant’ in the objective dimension, and ‘hedonic’, ‘self’, ‘belonging’, and ‘evasive’ in the substantive dimension. The detailed definitions and relationships of sub-dimensions of NFO can be found below in Figure 12).
Figure 1
Definitions and Relationships of Sub-dimensions of NFO
Note: This figure has been adapted from An & Lee (2024).
Using this classification system, the present study aims to identify varied motivational types driving users’ acquisition of cancer information and to examine how their methods of acquiring cancer information differ depending on these motivational profiles. Therefore, this study took a different approach and explored significant motivations for seeking (RQ 1-1) and scanning cancer information (RQ 1-2) independently by utilizing the eight sub-dimensions of NFO. Through this approach, the detailed reasons behind seeking and scanning for cancer information could be found.
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RQ 1-1. Which specific sub-dimensions of NFO have a significant effect on the degree of seekingcancer information?
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RQ 1-2. Which specific sub-dimensions of NFO have a significant effect on the degree of scanning cancer information?
Furthermore, this study assessed how different ways of acquiring information relate to two key cognitive outcomes: cancer knowledge and the perceived importance of cancer issues. These two outcomes are not only important indicators of how individuals process health-related information (Camaj & Weaver, 2013; Weaver, 1980), but are also closely linked to the development of health literacy (Kalichman & Rompa, 2000; Kaphingst et al., 2016; Paasche-Orlow & wolf, 2007), which plays a critical role in enabling patients to make informed decisions about their health. Health literacy, in this context, can be likened to an immune system—acting as a barrier against the ‘infection’ of medical misinformation. A higher level of health literacy equips individuals with the ability to filter out inaccurate or misleading cancer information, whereas limited health literacy can increase susceptibility to false claims (Garett & Young, 2022; Jordan et al., 2010). This was clearly illustrated in the earlier-mentioned fenbendazole scandal, where misinformation spread rapidly among the public due to gaps in understanding and lack of critical evaluation of health information.
In fact, one report indicated that South Koreans’ levels of health literacy are not sufficient to stave off a mass influx of misinformation in media. According to the report by Choi et al (2020), which surveyed 1,002 South Koreans between the ages of 19 and 69, it was found that only 29.1% of respondents have an ‘acceptable’ level of health literacy.3) In other words, the majority of South Koreans have difficulty accessing health information, much less understanding, evaluating, and using it (Choi et al., 2020). Furthermore, the group of people aged between 40 and 59 years old had the lowest proportion of respondents who showed an acceptable level of health literacy at 27.6% (Choi et al., 2020). Since this age group is the main target group included in many government programs for cancer prevention, these results indicate an urgent need for intervention.
Accordingly, this study focused on middle-aged South Koreans (aged 40–69) and examined whether motivational factors (NFO) and media use behaviors (seeking and scanning for cancer information) predict perceived importance of cancer issues and cancer knowledge—two cognitive outcomes strongly related to health literacy. The effects of these factors on cancer knowledge and perceived importance of cancer issues were analyzed in stages (stage 1=Model 1—motivational factor only; stage 2=Model 2—motivational and media usage factors together). The effects of these factors on cancer knowledge were addressed in RQ 2-1 and the effects on the perceived importance of cancer issues were addressed in RQ 2-2. These effects on respondents’ cognition are expected to differ depending on the types of motivations and the methods of acquiring cancer information.
The findings from this study offer practical implications for clinical practice, particularly in primary care settings where physicians often serve as the first point of contact for patients seeking health information. By understanding how patients acquire and interpret cancer information, physicians can better tailor communication strategies, identify gaps in health literacy, and provide more effective counseling. These insights can also support the development of educational materials for patients and community-based cancer prevention programs that align with real-world information consumption patterns.
Ⅱ. Methods
1. Procedure for Collecting Data
In order to find the answers to the research questions, this study conducted an online survey through a survey company, EMBRAIN, during the first four days of May 2023. This study was conducted after obtaining approval from the IRB of Ewha Womans University. The participants of this study were in their 40s, 50s, and 60s—the age range of the primary targets of the governmental programs for cancer prevention. Only survey respondents who hold South Korean citizenship and who do not have any mental disorders were included in this study. The number of participants in each age category were distributed in order to reflect the November 2022 census data from South Korean (MOIS, 2022). A total of 738 individuals were recruited, and after excluding incomplete responses4), 723 valid cases were retained for analysis.5) The final sample included 241 participants in their 40s (male=122, female=119), 258 in their 50s (male=130, female=128), and 224 in their 60s (male=110, female=114), totaling 362 males and 361 females.
2. Variables
2.1. Methods of Acquiring Cancer Information: Seeking and Scanning
In order to consider seeking and scanning as media-specific actions, this study measures the degree of each method by dividing media into multiple types. The types of media used in this study were types that middle-aged users frequently use, including newspapers, informational TV programs, TV entertainment programs, home shopping networks, search engines, social media (i.e. Facebook, Instagram, Twitter), video sharing sites (i.e. YouTube), and online news agencies.
The questionnaire for seeking and scanning cancer information used in this study was taken from the method of measurement used in previous studies (Hornik et al., 2013; Kelly et al., 2010; Shim et al., 2006). Seeking information was measured through the question, “How much do you search for cancer information via [MEDIA SOURCE]?” with answers on a 7-point scale, ranging from 1, “not at all”, to 7, “a lot”. Scanning information was measured through the question “How much do you, even without searching for it, come across cancer information via [Media Source]?” with answers on a 7-point scale, ranging from 1, “not at all”, to 7, “a lot”. The degree of each type of media use was calculated using the sum of all types of media for seeking and scanning, respectively.
2.2. Reasons: Motivation for Acquiring Cancer Information (Need for Orientation)
Minor adjustments were made to the method of measuring NFO, used by An and Lee (2024), to better suit cancer issues. Each sub-dimension was measured through a four or five item set of statements that participants scale from l to 7, where selecting 1 means “strongly disagree” and selecting 7 means “strongly agree”. The full questionnaire for the sub-dimensions can be found in Appendix A. All Cronbach alpha coefficients were higher than 0.8.
2.3. Outcome 1: Perceived Importance of Cancer Issues
By referring to the questionnaire that has been used in previous research on agenda-setting theory (e.g. Soroka, 2002; Wanta & Hu, 1993), the “most important problem facing the states” questionnaire (MIP), this study measured the perceived importance of cancer issues using the question, “What are important health problems that you feel worried about or feel that you need to solve?” They were asked to report not only the most important problem, but also asked to rank their top five health problems of concern from a selection of health issues. The categories of these health issues were taken from KOSTAT (Statistics Korea)’s data of primary death factors in people in their 40s through 60s in 2021 (KOSTAT, 2022). The categories of health issues are as follows: 1. Cancer; 2. Heart Disease6); 3. Cerebrovascular Disease7); 4. Respiratory Disease8); 5. Liver Disease9); 6. Obesity; 7. Diabetes10); 8. Hypertension11); 9. Dementia12). Based on the participants’ responses, the perceived importance of cancer issues was calculated via a point system, where 5 points were given to each person’s number 1 response, 4 points to each number 2 response, and so on. The participants who did not include cancer issues in his or her top five health issues were given zero points. Additionally, in order to measure the perceived importance of cancer issues without bias, the measurement of perceived importance of cancer issues was done at the start of the survey.
2.4. Outcome 2: Cancer Knowledge
The questions used in this study came from three studies which analyzed the cancer knowledge of South Koreans (Kim, 2012; Kim & Lee, 2006; Koh et al., 2011). The respondents in this study were given a true or false quiz with a ‘not sure’ option, and the questions on the quiz are about gastric, colon, liver, breast, and cervical cancers. There are five questions for each type of cancer. Male participants answered items on gastric, colon, and liver cancers, and female participants answered the same items plus the additional two items on breast and cervical cancers. The level of cancer knowledge was measured by summing the total number of correct responses, where 0 points are given for incorrect responses and 1 point is given for each correct response. The highest possible score totals to 25 points in women respondents and 15 points in men respondents. The table listing questions and answers can be found in Appendix B.
3. Data Analysis
The SPSS 28.0 program and R-studio were utilized in this study. Multiple linear regression analysis was applied for RQ 1, with 64 tests per mode (8 media types × 8 NFO variables). In order to avoid Type I error (α-inflation) due to the multiple regression analysis, the Benjamini–Hochberg procedure was adopted to control the false discovery rate. To address RQ 2, we conducted hierarchical regression analysis to analyze factors that affect cancer knowledge and the perceived importance of cancer issues. The hierarchical regression analysis was conducted through the application of two models: (1) Model 1 consisted of individual characteristics and motivational factors and (2) Model 2 consisted of individual characteristics, motivational factors and media usage factors. In addition, variance inflation factors (VIFs) were examined for all predictors (RQ 1 and 2), and they were all < 10, indicating no serious multicollinearity.
Ⅲ. Results
1. Participants’ Characteristics
The detailed statistics of participants’ individual characteristics (e.g. age, gender, income etc.) and their motivational levels; the results of participants’ degree of seeking and scanning cancer information; and the levels of cancer knowledge in men and women respondents are all described in Appendix C. The mean level of perceived importance of cancer issues was calculated to be 2.72 (range 0-5, SD=1.92), and it was selected as the most important among the health issues.
2. RQ 1: Investigating Reasons for Seeking and Scanning
For seeking cancer information (RQ 1-1), it was found that search engines were likely to be used by participants with a higher level of ‘intellectual’, ‘situational’, and ‘belonging’ motivations and by participants with a lower level of the ‘hedonic’ motivation. Informational TV programs were likely to be used by participants with a higher level of ‘topical’, ‘intellectual’, or ‘evasive’ motivations. Online news agencies were likely to be used by participants who had a higher level of ‘topical’, or ‘evasive’ motivations. TV entertainment programs were likely to be used by participants who had a higher level of ‘evasive’ motivation. A higher level of social media usage was found in participants who had a higher level of ‘hedonic’ or ‘evasive’ motivations. Home shopping networks were likely to be used by participants who had a higher level of ‘hedonic’ or ‘evasive’ motivations and participants who had a lower level of ‘intellectual’ motivation. Newspapers were likely to be used by participants with a higher level of ‘hedonic’ or ‘evasive’ motivations and participants with a lower of the ‘self’ motivation. Video sharing sites were found to have no significant connection with any of the eight motivations. The detailed results are shown in Table 1.
Table 1
Analyzing Factors of Seeking Cancer Information (From Most to Least Used Type of Media)
| Search Engines (β) | Informational TV programs (β) | Video Sharing Sites (β) | Online News Agencies (β) | TV Entertain ment Programs (β) | Social Media (β) | Home Shopping Networks (β) | Newspape r (β) | |
|---|---|---|---|---|---|---|---|---|
| Topical | .02 | .21** | .14 | .15* | .14 | .10 | .08 | -.02 |
| Intellectual | .16* | .15† | .00 | .13 | -.03 | -.06 | -.17* | -.05 |
| Situational | .18** | -.04 | -.05 | -.02 | .06 | -.04 | .03 | -.06 |
| Surveillant | .08 | -.01 | .07 | -.03 | -.03 | .07 | .01 | .01 |
| Hedonic | -.15† | .05 | .08 | -.02 | .09 | .17* | .21** | .28** |
| Self | .10 | .04 | .09 | .01 | -.11 | -.07 | -.16† | -.20* |
| Belonging | .10† | -.02 | .04 | .10 | .05 | .09 | .12 | .04 |
| Evasive | -.08 | .15† | .00 | .17* | .22** | .17* | .26** | .26** |
| Adjusted R² | .15 | .18 | .10 | .17 | .11 | .15 | .17 | .12 |
| F(8, 714) | 16.65*** | 21.33*** | 10.85*** | 19.65*** | 11.86*** | 16.61*** | 19.70*** | 13.18*** |
In terms of significant factors on media scanning (RQ 1-2), it was found that ‘intellectual’, and ‘self’ motivations positively affected scanning via informational TV programs, whereas the ‘evasive’ motivation had a negative effect. The degree of scanning via search engines was positively affected by ‘topical’ and ‘surveillant’ motivations. The degree of scanning via TV entertainment programs was only positively affected by the ‘surveillant’ motivation. The degree of scanning via online news agencies was positively related to ‘intellectual’ motivation. Video sharing sites were likely to be used by participants with a higher level of the ‘evasive’ motivation. Newspapers were likely to be used by participants with a lower level of the ‘situational’ motivation and participants with a higher level of the ‘surveillant’ motivation. Social media was highly used by participants with a higher level of ‘surveillant’ or ‘evasive’ motivations. Home shopping networks were highly used by participants with a higher level of the ‘surveillant’ motivation. The detailed results are shown in Table 2.
Table 2
Analyzing Factors of Scanning Cancer Information (From most to least used type of media)
| Informational TV programs (β) | Search Engines (β) | TV Entertain ment Programs (β) | Online News Agencies (β) | Video Sharing Sites (β) | Newspap er (β) | Social Media (β) | Home Shopping Networks (β) | |
|---|---|---|---|---|---|---|---|---|
| Topical | -.01 | .14* | .07 | .09 | .10 | .04 | .08 | .11 |
| Intellectual | .20* | .07 | .01 | .21* | .07 | .11 | .05 | -.11 |
| Situational | .05 | .02 | .02 | -.09 | .03 | -.12* | -.06 | -.04 |
| Surveillant | .10 | .15* | .14† | .11 | .08 | .17* | .16* | .18* |
| Hedonic | .03 | -.07 | .00 | .02 | -.05 | .02 | .05 | .03 |
| Self | .20* | .10 | .08 | .04 | .07 | .10 | .02 | .11 |
| Belonging | .01 | .07 | .10 | .01 | .00 | .05 | -.08 | .05 |
| Evasive | -.16† | -.01 | -.04 | .10 | .15† | .01 | .19* | .05 |
| Adjusted R² | .15 | .16 | .10 | .17 | .13 | .10 | .11 | .11 |
| F(8, 714) | 17.12*** | 17.72*** | 10.46*** | 19.80*** | 14.06*** | 11.53*** | 12.17*** | 12.14*** |
3. RQ 2: Investigating Antecedents to Outcomes of Seeking and Scanning
When considering factors that affect the degree of cancer knowledge (RQ 2-1), the factors were analyzed according to gender, because the total sum of cancer knowledge was different according to the gender of the respondents. The ‘topical’ motivation was positively associated with the level of men’s cancer knowledge in both models, whereas the ‘intellectual’ motivation was significant only in Model 1. Furthermore, men with a high tendency to seek via search engines all showed higher levels of cancer knowledge and men with a low tendency to seek cancer information via the home shopping networks.
Among women respondents, the ‘evasive’ motivation showed negative effects on cancer knowledge. The ‘intellectual’ motivation was seen to have a positive impact, but not in both models. It was also found that seeking via search engines and via online news agencies, had positive effects on the level of cancer knowledge. The detailed results of cancer knowledge in men and women respondents are shown in Table 3.
Table 3
Analyzing Factors of Cancer Knowledge
| Factors | Male (n = 362) | Female (n = 361) | ||||
|---|---|---|---|---|---|---|
| Model 1 (β) | Model 2 (β) | Model 1 (β) | Model 2 (β) | |||
| 1 | NFO/ Motivation | Topical | .17† | .17† | .02 | .00 |
| Intellectual | .17† | .10 | .21* | .15 | ||
| Situational | -.01 | -.03 | -.01 | -.03 | ||
| Surveillant | .08 | .08 | .07 | .05 | ||
| Hedonic | -.02 | .05 | .03 | .04 | ||
| Self | .04 | -.06 | .05 | .02 | ||
| Belonging | -.10 | -.15 | .17 | .14 | ||
| Evasive | -.05 | .03 | -.17* | -.19* | ||
| 2 | Seeking cancer information | Newspaper | .07 | -.02 | ||
| Informational TV programs | .04 | .06 | ||||
| TV Entertainment Programs | -.02 | .00 | ||||
| Home Shopping Networks | -.16† | .04 | ||||
| Search Engines | .12† | .15* | ||||
| Social Media | -.05 | -.03 | ||||
| Video Sharing Sites | -.05 | .10 | ||||
| Online News Agencies | .07 | .14* | ||||
| Scanning cancer information | Newspaper | -.06 | -.05† | |||
| Informational TV programs | .08 | .07 | ||||
| TV Entertainment Programs | .08 | -.01 | ||||
| Home Shopping Networks | .10 | .03 | ||||
| Search Engines | .05 | -.09 | ||||
| Social Media | -.02 | .02 | ||||
| Video Sharing Sites | -.04 | .01 | ||||
| Online News Agencies Evasive | -.02 | .03 | ||||
| Adjusted R² | .07 | .09 | .12 | .16 | ||
| △R² | .06 | .07** | ||||
| F | 4.61*** | 2.54*** | 7.10*** | 3.79*** | ||
When considering factors that affect the level of the perceived importance of cancer issues (RQ 2-2), it was found that respondents with higher levels of the ‘situational’ motivation showed higher levels of perceived importance of cancer issues. Furthermore, seeking via social media and scanning via informational TV programs and via the home shopping networks negatively affected the perceived importance of cancer issues. Inversely, seeking via video sharing sites and scanning via social media had a positive impact on the perceived importance of cancer issues. The detailed results are shown in Table 4.
Table 4
Analyzing Factors of Perceived Importance of Cancer Issues
| Factors | Perceived Importance of Cancer Issues | |||
|---|---|---|---|---|
| Model 1 (β) | Model 2 (β) | |||
| 1 | NFO/ Motivation | Topical | .03 | .04 |
| Intellectual | .01 | .00 | ||
| Situational | .27*** | .28*** | ||
| Surveillant | -.04 | -.04 | ||
| Hedonic | -.02 | -.03 | ||
| Self | -.07 | -.04 | ||
| Belonging | .05 | .06 | ||
| Evasive | .01 | -.02 | ||
| 2 | Seeking cancer information | Newspaper | .07 | |
| Informational TV programs | -.03 | |||
| TV Entertainment Programs | -.03 | |||
| Home Shopping Networks | .08 | |||
| Search Engines | .03 | |||
| Social Media | -.18*** | |||
| Video Sharing Sites | .08† | |||
| Online News Agencies | -.01 | |||
| Scanning cancer information | Newspaper | .02 | ||
| Informational TV programs | -.10* | |||
| TV Entertainment Programs | .06 | |||
| Home Shopping Networks | -.14** | |||
| Search Engines | -.01 | |||
| Social Media | .19*** | |||
| Video Sharing Sites | -.05 | |||
| Online News Agencies Evasive | .05 | |||
| Adjusted R² | .06 | .08 | ||
| △R² | .05** | |||
| F | 6.37*** | 3.64*** | ||
Ⅳ. Conclusion
1. Findings
In a prior study that served as the foundation for the present study, the authors showed that greater media coverage of cancer was significantly associated with increased adherence to cancer screenings among the public, yet the full explanation of how media exposure translated into cancer-preventative behavior could not be found(An & Lee, 2022). The present study, therefore, turned to an earlier stage of the pathway to preventive action by focusing on the primary target of governmental cancer-prevention programs, middle-aged South Koreans, and examining how they acquire and perceive cancer information before taking preventative action. This analysis offers valuable insights into how different methods of acquisition are shaped by distinct motivations and how these methods influence cognitive outcomes. These findings have practical implications for improving strategies of communicating cancer prevention among middle-aged adults and may help optimize future prevention efforts.
Firstly, this study investigated the causes of seeking and scanning cancer information through utilizing the categorization of NFO. From analyzing the intentional media use of middle-aged participants for seeking cancer information, a pattern was found in that highly used types of media were used to satisfy objective needs based on cognitive facets of information. Within the objective dimension, specifically, the ‘topical’, ‘intellectual’, and ‘situational’ motivations of participants mainly had a positive impact on the degree of seeking cancer information via frequently used types of media13). However, different patterns were found in the results of infrequently used types of media14). Usually, the ‘hedonic’ and ‘evasive’ motivations within the subjective dimension positively affected the degree of seeking via infrequently used types of media. The ‘evasive’ motivation in particular showed significant effects in the most types of media, regardless of the frequency of use.
When considered altogether, our findings on seeking suggest a clear pattern. Seeking through commonly used media for cancer information was primarily driven by motivations tied to the inherent purpose of information seeking, such as ‘topical’, ‘intellectual’, and ‘situational’ motivations. In contrast, seeking through rarely used media appeared to be driven by motivations less directly related to the information itself and more related to the current mood of the user, such as ‘hedonic’ and ‘evasive’ motivations. This indicates that most seeking reflects goal-oriented effort grounded in interest in the topic and a desire for knowledge, whereas a smaller portion of seeking may be shaped by entertainment-oriented or escapist motives. Future research should, therefore, pay closer attention to these relatively infrequent forms of seeking in case they expose a connection to the acceptance of undesirable information.
Additionally, compared to seeking, scanning was much more closely tied to ‘surveillant’ motivation—that is, using media to monitor socially relevant issues. In most media types, especially in search engines and TV entertainment programs, it was found that participants’ needs for surveillance had a positive effect on media usage for scanning cancer information. That is to say, the major goal of scanning cancer information is monitoring the social climate through cancer information. This implies that scanning may operate as a mechanism of ambient awareness, allowing individuals to remain attuned to socially salient cancer-related cues and to monitor the broader social climate in a low-cost manner. At the same time, the significant role of intellectual motivation suggests that scanning is not merely passive exposure; it can also reflect a purposeful attempt to gradually accumulate reliable background knowledge, distinguishing scanning as both a social-monitoring practice and a “light-touch” learning strategy.
This study was able to more clearly differentiate and more thoroughly develop the concept of seeking and scanning than previous studies. In previous studies (e.g. Hornik et al., 2013; Kelly et al., 2010; Niederdeppe et al., 2007; Shim et al., 2006), the definitions were divided according to the users’ strength of attention. However, through the application of NFO in agenda-setting theory, this study was able to investigate users’ specific reasons behind seeking and scanning for cancer information thereby providing a new perspective beyond what prior research has addressed.
Secondly, this clarification led to differences in the results of outcomes that seeking and scanning affected. Seeking cancer information mainly influenced the level of cancer knowledge, and scanning cancer information primarily had an impact on the level of the perceived importance of cancer issues. In terms of cancer knowledge, men’s level of cancer knowledge was affected by seeking via home shopping networks and seeking via search engines. Specifically, it was found that seeking via search engines was an effective way to increase the middle-aged men’s level of cancer knowledge. It was also found that seeking via search engines and online news agencies were significant ways to increase the middle-aged women’s level of cancer knowledge. Since seeking cancer information via search engines was a common way to increase cancer knowledge in both men and women respondents, it can be said that searching cancer information through search engines was the most effective when forming cancer knowledge.
When it comes to the perceived importance of cancer issues, several types of scanning, such as scanning via social media, informational TV programs and home shopping networks, had significant effects on the level of perceived importance of cancer issues. Particularly, scanning via social media had a positive impact on an increase in the perceived importance of cancer issues, unlike the other types of media scanning. Additionally, it is worth noting that seeking via social media, which is the same media type but through a different method, had a negative impact. These results illustrate not only that social media functions significantly when increasing middle-aged people’s level of perceived importance, but also that information on social media that is consumed through scanning has a positive impact on the perceived importance of cancer issues. In addition to considering the methods for increasing the perceived importance of cancer issues, we should also consider the fact that ‘situational’ motivation was likely to increase the users’ levels of the perceived importance of cancer issues. These findings capture only fragmentary associations among the significant variables, so future research should explicitly test the links and mechanisms connecting these results to enable a more in-depth interpretation.
2. Limitations
Despite the abundance of implications offered by this study, several limitations should be acknowledged. The most significant limitation is that this study does not provide direct solutions for preventing incidents involving the spread of cancer misinformation, such as the fenbendazole scandal. This limitation stems from the study’s primary aim: to explore the characteristics of middle-aged users in relation to their methods of acquiring cancer information. Nevertheless, the insights gained from this investigation contribute to a deeper understanding of how accurate knowledge and conceptions about cancer are formed. Thus, although this research may not provide steps for immediate practical intervention, the authors hope it will be regarded as a foundation for future development of effective countermeasures.
Another limitation concerns the measurement of seeking and scanning itself. Consistent with prior research, the present study relied on self-reported and recall-based measures to assess participants’ information acquisition behaviors. As earlier studies have noted (e.g. Kelly, et al., 2010; Ruppel, 2016), such measures are susceptible to recall error and social desirability bias, and they may not fully capture the routine nature of information scanning, which occurs incidentally. Future research could address these limitations by employing experimental or quasi-experimental designs, as well as more objective behavioral measures (e.g., digital trace data or ecological momentary assessment) to more precisely estimate the effects of seeking and scanning on cancer-related cognition. Such approaches would also help inform how to better create more concrete, evidence-based strategies to curb the spread of health misinformation.
In addition, certain contextual and methodological characteristics in this study should be considered when interpreting the findings. Regarding the methodology, the characteristics of data collection should be more explicitly considered. The data in this study were collected through an online survey, which may have yielded a sample biased toward individuals who were likely to have greater internet access and digital literacy. Moreover, the middle-aged participants in this study were comprised of both Baby Boomers and Generation X, and potential cohort differences in information acquisition patterns should be taken into account— especially when examining whether the determinants and outcomes of seeking and scanning vary across cohorts within the middle-aged population.
When it comes to media context, South Korea exhibits unique cultural characteristics, including a strong presence of health-related content on home shopping channels and TV entertainment programs. These features may have influenced both participants’ media use behaviors and their exposure to cancer-related content. Theoretically, the media-specific patterns observed in this study suggest that seeking and scanning are influenced by the structural features of different media genres and platforms. However, we did not find strong evidence that scanning via TV entertainment programs is driven by ‘surveillant’ motivation. After adjusting for multiple comparisons, the association between scanning via TV entertainment programs and ‘surveillant’ motivation remained statistically significant but small in magnitude. This finding warrants further research on additional drivers and contextual mechanisms. Future research should test this mechanism more directly and examine how entertainment-driven and commercialized health content creates different opportunities and incentives for seeking versus scanning.
3. Practical and Academic Considerations
Based on the findings of this study, the authors would like to raise several practical and academic considerations. Firstly, there is a pressing need for clear and effective guidelines that address health misinformation on media platforms, particularly in search engines. However, such guidelines remain underdeveloped. This study’s results support the idea that search engines—one of the primary sources of health information in South Korea (Choi et al., 2020)—play a critical role in shaping users’ cancer-related knowledge. Case in point, even after the scandal, the search results of the phrase ‘effectiveness of fenbendazole’ in search engines included many blogs that still mentioned the anticancer effects of fenbendazole, including some blogs written by medical experts (e.g. doctors, pharmacists). However, the National Cancer Center and the South Korean government declared that it was a waste of time to test the anticancer effect of fenbendazole, since it was already known to be ineffective. Since blogs with misinformation can still be easily found, despite this declaration, it is obvious that in order to prevent public confusion, stronger regulatory guidelines for misinformation in search engines should be considered in South Korea.
Secondly, the results regarding the perceived importance of cancer issues illustrate a pressing concern: further research is needed to explore how scanning behaviors on social media influence individuals’ perception of cancer-related importance. ‘Short-form’ videos on social media have become particularly popular recently. Considering the characteristics of short-form videos, wherein viewers just watch without a specific purpose and without paying close attention, watching this format is seemingly more closely related to scanning information than to seeking. Therefore, future studies should concentrate on the viewing of short-form videos as the method of scanning and the effects of viewing short-form on people’s health literacy and on their trust on misinformation.
Notes
This type of content plays predominantly short, vertically-orientated videos on a loop. Examples include YouTube Shorts, Instagram Reels, and TikTok Videos.
Two sub-dimensions of NFO from An and Lee (2024) were renamed in order to clarify their respective roles. The ‘substantive’ sub-dimension was renamed ‘intellectual’, and the ‘aesthetic’ sub-dimension was renamed ‘evasive’. The definitions of these sub-dimensions, however, were not changed.
In this report (Choi et al., 2020), the level of health literacy of respondents was measured on a scale of 0 to 16 points, and a score of 0-8 points was classified as ‘insufficient’, 9-12 points as‘borderline’, and 13-16 points as ‘acceptable’.
Consistent with the criteria stated in the IRB application, we excluded respondents who reported having a mental or intellectual disability, as well as respondents who were not South Korean citizens.
Using G*Power 3.1.9, the minimum required sample size for multiple regression analysis with 31 predictors was calculated to be 383, based on an alpha level of .05, statistical power of .95, and a small effect size of .10. The number of participants used in the present study exceeds this required sample size.
Firstly, this study investigated the causes of seeking and scanning cancer information through utilizing the categorization of NFO. From analyzing the participants’ intentional media use for seeking cancer information, a pattern was found in that highly used types of media were used to satisfy objective needs based on cognitive facets of information. Within the objective dimension, specifically, the ‘topical’ and ‘intellectual’ motivations of participants mainly had a positive impact on the degree of seeking cancer information via frequently used types of media
Appendices
Appendix
Appendix A
Questionnaire of Each Type of Sub-Dimension of NFO
| Dimension | Type | Questionnaire |
|---|---|---|
| Objective Dimension | Topical | I’m intrigued when I come across information on cancer |
| Cancer issues pique my curiosity | ||
| I tend to pay closer attention to cancer related plotlines in dramas or similar media | ||
| News about celebrities getting cancer grabs my attention | ||
| Intellectual | I want to acquire up-to-date information related to cancer | |
| I want to obtain credible information related to cancer | ||
| I want to get cancer information that is pertinent to me | ||
| I want to go in-depth into up-to-date cancer information that I find | ||
| Situational | Cancer has played a large role in my life | |
| I’m in a situation that requires understanding of and judgement on cancer | ||
| I have experienced a situation where I needed information on cancer | ||
| I think that learning about cancer now will be beneficial to me in the future | ||
| Surveillant | I want to find cancer information to gain context about societal issues | |
| I acquire information on cancer because I want to make sure that medical professionals are responsibly dealing with cancer | ||
| I want to use knowledge of cancer to make sure that the government is implementing proper health programs and policies | ||
| I want to be critical of the information provided by famous medical professionals and medical interest groups | ||
| Subjective Dimension | Hedonic | I want to spend my downtime consuming cancer-related content |
| I consume cancer-related content in my spare time | ||
| I look at information on cancer for no particular reason | ||
| I feel reassured through seeing information related to cancer | ||
| Self | I feel confident in my opinion through acquiring information on cancer | |
| I can improve my quality of life through acquiring cancer information | ||
| I want to find support for my opinions on cancer | ||
| I want to adjust my life goals based on what I learn about cancer | ||
| Belonging | I want to use knowledge of cancer to build a rapport with others | |
| I want to talk with people in my life about information that I acquire about cancer | ||
| I want a sense of unity that comes from my thoughts being the same as the thoughts of others | ||
| I desire to feel satisfaction from being affiliated with society | ||
| Evasive | I want to escape my life through consuming cancer-related content | |
| I can stop thinking about work through consuming cancer-related content | ||
| I can relieve stress from my personal relationships through consuming cancer-related content | ||
| I can imagine a different version of myself through consuming cancer-related content |
Appendix B.
Questions and Answers about Cancer Knowledge
| Questions | O/X/Not Sure | |
|---|---|---|
| Gastric Cancer (general) | Gastric cancer commonly occurs in young people. | X |
| Common causes of gastric cancer include salty foods, spicy foods, and burned foods. | O | |
| Sudden, dramatic weight loss may occur as a symptom of gastric cancer. | O | |
| A gastroscopy is needed to identify gastric cancer. | O | |
| In order to identify early stages of gastric cancer, screenings are recommended every 3 months. | X | |
| Colon Cancer (general) | Colon cancer usually occurs in old age. | O |
| The main cause of colon cancer is smoking. | X | |
| One main symptom of colon cancer is blood in feces. | O | |
| X-rays are required to identify colon cancer. | X | |
| To detect early stage colon cancer, screenings are needed at least once a year. | O | |
| Liver Cancer (general) | Liver cancer usually occurs in men. | O |
| A person with chronic Hepatitis-B or C is likely to contract liver cancer. | O | |
| Liver cancer doesn’t have distinct symptoms in its early stage. | O | |
| Ultrasonography is needed to identify liver cancer. | O | |
| To detect early stage liver cancer, high risk individuals need to be screened at least once a year. | X | |
| Breast Cancer (only female) | Women with family members who have been diagnosed with breast cancer are more likely to contract it. | O |
| The probability of contracting breast cancer increases when individuals consume large amounts of fatty meats. | O | |
| Secretion from the nipple that hasn't occurred before is nothing to worry about. | X | |
| Breast self-examination is necessary in order to detect early stage breast cancer. | O | |
| Breast self-examination should be done once every 6 months in order to detect breast cancer. | X | |
| Cervical Cancer (only female) | The longer a woman takes contraceptives, the more likely she is to contract cervical cancer. | O |
| Main cause of cervical cancer is a human papillomavirus infection gotten through sexual intercourse. | O | |
| After contracting cervical cancer, a possible symptom is vaginal bleeding following strenuous exercise. | O | |
| Regular examination of cervical cells leads to early detection of cervical cancer. | O | |
| Cervical cell testing is required once a month. | X |
Appendix C.
Participants’ Characteristics
(N=723)
| Items (participants’ individual characteristics) | Number (%) of respondents | |||||
| Demographic Variables | Gender | Male | 362 (50.1) | |||
| Female | 361 (49.9) | |||||
| Age | 40s | 241 (33.3) | ||||
| 50s | 258 (35.7) | |||||
| 60s | 224 (31.0) | |||||
| Marital Status | Married | 567 (78.4) | ||||
| Unmarried | 156 (21.6) | |||||
| Education | Elementary | 2 (0.3) | ||||
| Middle School | 6 (0.8) | |||||
| High School | 153 (21.2) | |||||
| Undergraduate School | 475 (65.7) | |||||
| Graduate School | 87 (12.0) | |||||
| Socioeconomic Variables | Employment | Employed | 504 (69.7) | |||
| Unemployed | 219 (30.3) | |||||
| Income | less than 2 million won | 573 (79.3) | ||||
| 2-3 million won | 105 (14.5) | |||||
| 3-4 million won | 38 (5.3) | |||||
| 4-5 million won | 6 (0.8) | |||||
| 5-6 million won | 1 (0.1) | |||||
| Region | Large Cities | 536 (74.1) | ||||
| Small to Medium Cities | 162 (22.4) | |||||
| Rural Areas | 25 (3.5) | |||||
| Items (participants’ motivational levels) | Mean | SD | Cronbach α | |||
| Motivational Variables | Objective Dimension | Topical | 4.76 | 1.13 | 0.93 | |
| Intellectual | 5.24 | 1.10 | 0.94 | |||
| Situational | 4.34 | 1.25 | 0.82 | |||
| Surveillant | 4.32 | 1.25 | 0.88 | |||
| Total | 4.67 | 1.00 | - | |||
| Objective Dimension | Hedonic | 3.44 | 1.27 | 0.90 | ||
| Self | 4.05 | 1.32 | 0.94 | |||
| Belonging | 3.84 | 1.34 | 0.95 | |||
| Evasive | 3.41 | 1.34 | 0.93 | |||
| Total | 3.69 | 1.20 | - | |||
| Items (participants’ degree of seeking and scanning) | Mean | SD | ||||
| Seeking | Newspaper | 2.22 | 1.36 | |||
| Informational TV programs | 4.52 | 1.42 | ||||
| TV Entertainment Programs | 3.49 | 1.57 | ||||
| Home Shopping Networks | 2.27 | 1.37 | ||||
| Search Engines | 5.40 | 1.29 | ||||
| Social Media | 3.35 | 1.61 | ||||
| Video Sharing Sites | 4.37 | 1.6 | ||||
| Online News Agencies | 4.26 | 1.53 | ||||
| Total | 3.79 | 0.87 | ||||
| Scanning | Newspaper | 3.95 | 1.69 | |||
| Informational TV programs | 4.77 | 1.25 | ||||
| TV Entertainment Programs | 4.33 | 1.43 | ||||
| Home Shopping Networks | 3.62 | 1.71 | ||||
| Search Engines | 4.58 | 1.35 | ||||
| Social Media | 3.73 | 1.59 | ||||
| Video Sharing Sites | 4.17 | 1.50 | ||||
| Online News Agencies | 4.22 | 1.40 | ||||
| Total | 4.17 | 1.01 | ||||
| Items (participants’ levels of cancer knowledge) | Mean / Total Possible | SD | ||||
| Cancer Knowledge | Gastric Cancer | Male (n = 362) | Total | 0.93 | ||
| Female (n = 361) | 4.20 / 5 | 0.87 | ||||
| Colon Cancer | Male (n = 362) | 3.53 / 5 | 1.14 | |||
| Female (n = 361) | 3.58 / 5 | 1.02 | ||||
| Liver Cancer | Male (n = 362) | 2.89 / 5 | 1.13 | |||
| Female (n = 361) | 3.07 /5 | 1.11 | ||||
| Breast Cancer | Female (n = 361) | 3.35 /5 | 0.97 | |||
| Cervical | Female (n = 361) | 2.82 / 5 | 1.21 | |||
| Average Total | Male (n = 362) | 10.49 / 15 | 2.43 | |||
| Female (n = 361) | 17.01 / 25 | 3.45 | ||||
References
, , , , , , & (2020). A study for improving health literacy. Korea Institute for Health and Social Affairs. https://repository.kihasa.re.kr/handle/201002/37301
, & (2000). Functional health literacy is associated with health status and health-related knowledge in people living with HIV-AIDS. Journal of Acquired Immune Deficiency Syndromes, 25(4), 337-344. [PubMed]
KOSTAT, Statistics Korea. (2022, September 27). Statistics on cause of death in 2021. https://kostat.go.kr/boardDownload.es?bid=218&list_no=420715&seq=6
MFDS, Ministry of Food and Drug Safety. (2014). Eleven people apprehended for false and exaggerated advertisement of ‘cancer-curing’ foods — Crackdown on misleading ads found in online cancer patient communities. https://www.korea.kr/briefing/pressReleaseView.do?newsId=155953519&pWise=sub&pWiseSub=J2
MOHW, Ministry of Health and Welfare. (2021). The 5th health plan 2030 (2021-2030). Korea Health Promotion Institute. https://www.khealth.or.kr/fileDownload?titleId=33248&fileId=1&fileDownType=C
MOIS, Ministry of the Interior and Safety. (2022). Population distribution by age. https://jumin.mois.go.kr/ageStatMonth.do
, , , , , , , , & (2007). Examining the dimensions of cancer-related information seeking and scanning behavior. Health communication, 22(2), 153-167. [PubMed]
(2016). Scanning health information sources: Applying and extending the comprehensive model of informati on seeking. Journal of health communication, 21(2), 208-216. [PubMed]
, , & (2006). Cancer information scanning and seeking behaviour is associated with knowledge, lifestyle choices, and screening. Journal of Health Communication, 11, 157-172. [PubMed]
(2005). The communications revolution and cancer control. Nature reviews cancer, 5(10), 828-835. [PubMed]
- 투고일Submission Date
- 2025-10-31
- 수정일Revised Date
- 2026-02-04
- 게재확정일Accepted Date
- 2026-02-19
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