Video-Based Education in Lung Cancer Screening.

Abstract

Lung cancer (LC) is the leading cause of cancer mortality in the USA; the American Cancer Society (ACS) estimates upwards of 220,000 new cases will be diagnosed this year. Recently, the Center for Medicare/Medicaid Services (CMS) agreed to cover LC screening with low-dose computed tomography (CT) for patients; however, CMS requires prior documentation of a shared decision-making (SDM) visit between the patient and the referring clinician to inform them about risks of screening. LC screening programs have begun to use YouTube for patient recruitment, education, and marketing of screening. The objective of this study is to shed light on the role of YouTube in lung cancer screening in terms of guidelines, screening options, target population, steps after screening, and risks and benefits of screening. We searched YouTube.com ™ to identify videos dealing with lung screening using the keywords: lung cancer screening. Videos without sound, uploaded before 2009, longer than 20 min, duplicate videos, and videos in a language other than English were excluded. This method yielded 123 videos that fit criteria. Videos were coded for inclusion of LC screening process, risks and benefits of screening, screening guidelines, risk factors for LC, and treatment options after LC diagnosis. One hundred twenty-three videos had a cumulative 261,261 views across all videos. A total of 38.7% of the videos included no mention of United States Preventive Services Task Force (USPSTF) or CMS guidelines for LC screening. Only 30% included any mention of the risks associated with screening: 14% mentioned false positives, 12% radiation, and 4% anxiety associated with screening. Ninety-two percent of all videos sampled were intended for patients, and the majority of videos were created by medical institutions (66%) and news channels (17%). Lung cancer screening videos on YouTube's platform have garnered a substantial amount of views. While all videos sampled highlighted the benefits of LC screening, the majority fail to discuss the risks associated with the screening process. Most videos were produced for marketing purposes rather than educational and therefore should not be used as a substitute for SDM visits.