Cancer Literacy and Social Determinants of Health: An Epidemiological Analysis of Trust, Digital Engagement, and Healthcare Utilization in Cancer Information Seeking

The rise of online health information has increased access to cancer resources but also amplified misinformation, creating trust gaps that threaten prevention, treatment, and health equity. This study examined how trust in cancer information sources, online information-seeking, and healthcare perceptions relate among U.S. adults. Guided by the health information seeking behavior, the socioecological model, and the structural influence model of health communication, data from the 2022 Health Information National Trends Survey (N = 6,197) were analyzed with logistic regression, mediation, and moderation modeling, controlling for demographics. Trust in government agencies predicted greater cancer information seeking (odds ratio [OR] = 1.94, p < .001) than trust in physicians (OR = 1.21, p = .07), suggesting trust in public institutions plays a stronger role than trust in individual clinicians in motivating people to seek cancer information. Digital confidence mediated the link between frequent internet use and lower frustration (β = 0.18, p < .001), helping internet users feel less overwhelmed. Trust in government sources moderated the positive association between healthcare use and perceived care quality (β = 0.22, p = .002), while conflicting guidance reduced trust in scientists (β = –0.16, p < .01). Institutional trust and digital confidence jointly shape equitable engagement with health information. Implications for social change include promoting digital health literacy, improving institutional transparency, and empowering underserved communities to make informed cancer decisions that improve prevention, access, and population health.