AUA 2022: Social Media in Urologic Oncology

( The 2022 American Urological Association (AUA) Annual Meeting included the Society of Urologic Oncology (SUO) session and a presentation by Dr. Kara Watts discussing social media in urologic oncology. Dr. Watts started her presentation by noting that social media has many potential uses, including interacting/promoting, advocating, and education/learning. Globally, more than 4 billion people use social media, and a recent survey suggested that 99% of young European urologists had a social media account. Early work assessing the utilization of social media in Urology, from a survey of AUA members in Urology in 2017, suggested that 74% of respondents had a social media account (Facebook and YouTube were the most common), and 33% reported that social media had an impact on their practice. Furthermore, data from #AUA18 noted that there were 18,863 tweets from 3,887 contributors, leading to 73,878 million impressions.

Dr. Watts notes that the COVID-19 pandemic subsequently lead to the growth of social media in academic urology. A study from Manning et al.1 assessed the increase in both tweet count timeline account creation, noting a substantial increase during the pandemic. Additionally, there were several top performing academic programs, as highlighted. 

Urology associations, such as the European Association of Urology often uses Twitter to promote its guidelines, specifically with regards to timely guideline updates. Twitter mentions has also been shown to increase academic citations. Hayon and colleagues2 assessed 213 papers from 7 prominent urologic journals 37 months after publication. Articles were evaluated with 2 citation based "bibliometrics" (Scopus, Google Scholar) and Twitter mentions were tracked using the Altmetric Bookmarklet. Overall, 73% of articles had at least 1 Twitter mention, and 42% of Twitter mentions occurred within the first week of the online publication date. Articles mentioned on Twitter had 2.0-fold more Scopus citations (p <0.01), and 2.3-fold more Google Scholar citations (p <0. 01) compared to articles with no Twitter mentions. A total of 8.9% of papers were tweeted by their authors, which were associated with a 12.3 (2.0-fold) and 15.5 (1.8-fold) mean citation increase for Scopus and Google Scholar (p < 0.01 and p = 0.01, respectively) compared to articles not shared by their authors on Twitter.

With regards to interacting and engaging on Twitter, the COVID-19 pandemic also created unique opportunities for timely discussion of   of complex cases. Shah and colleagues3 sought to determine the usefulness of social media for rapid communication with experts to discuss strategies for prioritization and safety of deferred treatment for urologic malignancies during COVID-19 pandemic, and to determine whether the discourse and recommendations made through discussions on Twitter were consistent with the current peer-reviewed literature regarding the safety of delayed treatment. Active discussions on Twitter provided real-time updates on the changing landscape of the restrictions being placed on non-urgent care. For separate discussion threads on prostate cancer and bladder cancer, dozens of specialists with expertise in treating urologic cancers could be engaged in providing their expert opinions as well as share evidence to support their recommendations. Dr. Shah’s analysis of published studies addressing the safety and extent to which delayed cancer care does not compromise oncological outcome revealed that most prostate cancer care and certain aspects of the bladder and kidney cancer care can be safely deferred for 2-6 months, whereas urothelial bladder cancer and advanced kidney cancer require a higher priority for timely surgical care. With regards to prostate cancer management, the following figure highlights the frequency and strength of recommendations with the location of specialists responding to Twitter discussions: 


Dr. Watts also highlighted that Twitter can be used for advocacy. For example, when the NCCN prostate cancer guidelines recently removed the word “preferred” for active surveillance as the management of low risk prostate cancer, several thought leaders in prostate cancer took to Twitter to voice their disagreement, leading to a wave of support, and ultimately leading to the NCCN to reverse this change. Dr. Watts cautions that not all information on Twitter with regards to genitourinary cancer is necessarily accurate. Alsyouf and colleagues4 evaluated the accuracy of the most popular articles on social media platforms pertaining to genitourinary malignancies, and to identify the prevalence of misinformation available to patients. Between August 2017 and August 2018, the 10 most shared articles on popular social media platforms (Facebook, Twitter, Pinterest, and Reddit) were identified for prostate cancer, bladder cancer, kidney cancer, testis cancer, and PSA testing. These articles were reviewed for accuracy by comparing the article information against available scientific research and consensus data, classified as accurate, misleading or inaccurate. This study found that articles pertaining to prostate cancer were the most shared across all social media platforms (399,000 shares), followed by articles pertaining to kidney cancer (115,000), bladder cancer (17,894), PSA testing (8,827) and testicular cancer (7,045). The prevalence of inaccurate or misleading articles was high:

  • Prostate cancer, 7/10 articles
  • Kidney cancer, 3/10 articles
  • Bladder cancer, 2/10 articles
  • Testis cancer, 2/10 articles
  • PSA testing, 1/10 articles

Disturbingly, there was a significantly higher average number of shares for inaccurate (54,000 shares; p < 0.01) and misleading articles (7,040 shares; P < 0.01) than for accurate articles (1,900 shares).

Dr. Watts concluded her presentation discussing social media in urologic oncology with the following take-home messages:

  • Whether you like social media or feel unsure, social media is a powerful resource
  • Twitter leads to academic citations and visibility
  • Social media is here to stay, but we must also stay mindful about content

Presented by: Kara Watts, MD, Montefiore Medical Center, Bronx, NY

Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Assistant Professor of Urology, Georgia Cancer Center, Augusta University/Medical College of Georgia, @zklaassen_md on Twitter during the 2022 American Urological Association (AUA) Annual Meeting, New Orleans, LA, Fri, May 13 – Mon, May 16, 2022.  


  1. Manning E, Calaway A, Dubin JM, et al. Growth of the Twitter presence of academic urology training programs and its catalysis by the COVID-19 pandemic. Eur Urol. 2021 Aug;80(2):261-263.
  2. Hayon S, Tripathi H, Stormont IM, et al. Twitter mentions and academic citations in the urologic literature. Urology. 2019 Jan;123:28-33.
  3. Shah P, Kim FJ, Mian BM. Genitourinary cancer management during a severe pandemic: Utility of rapid communication tools and evidence-based guidelines. BJUI Compass. 2020 May;1(2):45-59.
  4. Alsyouf M, Stokes P, Hur D, et al. ‘Fake News’ in urology: Evaluating the accuracy of articles shared on social media in genitourinary malignancies. BJU Int 2019 May 2 [Epub ahead of print].