#SurgOnc: Global discussions about surgical cancer care on Twitter during COVID-19.

Abstract

11045 Background: Social media platforms such as Twitter are highly utilized to communicate about cancer care. Although surgery is the primary treatment for solid malignancies, little is known about public perceptions or communication behaviors regarding this treatment modality. Further, prolonged lockdowns and widespread delays of planned operations during the COVID-19 pandemic have magnified the importance of virtual communication about surgical cancer care. Methods: Tweets referencing cancer surgery were collected from January 2018 to January 2022 using Twitter’s Application Programming Interface. Account metadata was used to predict user demographic information and to compare tweeting metrics across users. Natural language processing models were applied to tweet content to resolve common topics of conversation and to classify tweets by cancer type. Results: There were 442,840 original tweets about cancer surgery by 262,168 users. Individuals accounted for most users (65%) while influencers accounted for the least (1.4%). Influencers made the most median impressions (19,139). Of 240,713 tweets discussing surgery for specific cancers, breast (20%) and neurologic (17%) cancers were most mentioned. When adjusting for national rates of procedures performed, tweets about surgery for neurologic cancers were the most common (231 tweets per 1000 procedures) whereas those for urologic cancers were the least common (15 tweets per 1000 procedures). Discussions about cancer surgery research made up 31% of tweets before the pandemic but only 11% of tweets during the pandemic. During the pandemic, concern regarding COVID-19 related delays was the most tweeted topic (23%). Cancer surgery research was most cited by oncologists, as well as in tweets about hepatopancreatobiliary and colorectal cancers. The cost of surgery was commonly mentioned in tweets about breast and gynecologic cancers and contained the most negative sentiment score (-0.7). Conclusions: Twitter was highly utilized to discuss surgical cancer care during the COVID-19 pandemic. During the pandemic, conversations shifted focus from research to survivorship and reflected real-time events such as COVID-19-related surgical delays. We identified the financial burden of cancer care as a commonly held concern among patients discussing cancer surgery on social media. Future public health outreach about cancer surgery may be optimized by coordinating with influencers and by targeting topics of concern like cost of surgery and undermentioned content like urologic cancers. Twitter’s role as a platform for research dissemination was disrupted by the COVID-19 pandemic, and further tracking is needed regarding online research discussions after the pandemic.