AUA 2022: Accuracy and Racial/Ethnic Representation of Prostate Cancer Screening Videos on Youtube and Tiktok

( The 2022 American Urological Association (AUA) Annual Meeting featured work from Mr. Max Abramson and colleagues from Albert Einstein College of Medicine, presenting results of their study assessing the racial/ethnic representation and content accuracy of prostate screening videos on Youtube and Tiktok. Compared to white men, the mortality rate from prostate cancer and the risk of advanced stage disease are higher among Black men and Hispanic men, respectively.  Despite the prevalence of prostate cancer among Black and Hispanic males, disparities in prostate cancer screening and diagnosis of stage continue to persist. Eighty percent of American adults rely on the internet for health-related information, but few studies have assessed the social media content for prostate cancer screening, especially among the high-risk cohorts. As such, Mr. Max Abramson and colleagues compared the presentation of prostate cancer videos on Youtube and Tiktok and evaluated its content and racial/ethnic representation.

The phrase "prostate cancer and screening" was searched on both Youtube and Tiktok. The top 50 results were retrieved and analyzed by three reviewers using DISCERN, PEMAT, Likert, and consensus approach. DISCERN and PEMAT are validated criteria for the evaluation of the quality, understandability, and actionability of consumer health information, respectively. A DISCERN score of 4, PEMAT understandability percentage of 75%, and PEMEAT actionability percentage of 75% defines high quality consumer health information. The Likert scale was used to compare the information presented on social media to the guidelines provided by the American Urological Association and National Comprehensive Cancer Network guidelines. Racial and ethnic representation was concluded by a consensus of all three reviewers.

The median number of views was higher on Tiktok than on Youtube, 23,150 and 909, respectively; however, 94% of Youtube videos were educational and information versus 56% on Tiktok. PSA blood test, age-specific recommendations, and family history of prostate cancer were discussed in 96%, 54%, and 50% of Youtube videos, respectively, versus 14%, 10%, and 6% on Tiktok videos, respectively (Figure 1). Black and Hispanic representation was shown in 20% and 12% of Tiktok videos and 10% and 6% of Youtube videos, respectively. Eight percent of Tiktok videos and 46% of Youtube videos specifically discussed high-risk racial/ethnic groups. The majority of Youtube and Tiktok videos had low to moderate quality consumer health information (98% and 100%, respectively) and moderate to high levels of misinformation (88% and 100% respectively).

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Figure 1. Comparison of Prostate Cancer Screening on Youtube and Tiktok

Through this study investigating the content accuracy and racial/ethinic representation of prostate cancer screening videos on Youtube and Tiktok, Mr. Max Abramson and colleagues presented the following conclusions:

  • Prostate cancer screening videos are readily available and viewed on social media, but neither provide quality consumer health information nor proper Black and Hispanic representation.
  • High risk racial groups were underrepresented and not discussed in the screening criteria on either platforms.
  • Videos on Youtube and Tiktok had low understandability, low actionability, lack of diversity, and significant misinformation which may be associated with the continued disparities in prostate cancer screening.

Given the results, the authors suggested three recommendations to healthcare professionals and organizations:

  1. Should publish diverse, high-quality, and accurate content about prostate cancer
  2. Amend or delete old, outdated videos and report videos with misleading, inaccurate information
  3. Guide patients to videos that are accurate and appropriate

Presented by: Max Abramson, BA, Albert Einstein College of Medicine, Bronx, New York

Written by: Minh-Chau Vu, B.S., Department of Urology, University of California, Irvine during the 2022 American Urological Association (AUA) Annual Meeting, New Orleans, LA, Fri, May 13 – Mon, May 16, 2022.

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