YouTube lacks quality information on prostate cancer screening in Black men

The overall quality of YouTube videos that researchers watched about prostate cancer screening in Black men was suboptimal, a recent analysis showed.

The videos’ ratings did not improve when the presenters of the videos were Black men, who the researchers noted are “disproportionately impacted by prostate cancer.”

“This is the first study to look at the quality of prostate cancer screening information specifically for Black men on YouTube,” Nicholas Shungu, MD, study co-author and assistant professor of family medicine at the Medical University of South Carolina, told Healio Primary Care.

He said previous studies have shown that about half of Black individuals go online to obtain health information, and YouTube is the most used social media platform among this population.

The researchers analyzed videos that appeared on the first page of search results for “prostate cancer screening in Black men” on YouTube. To be included in the study, the video needed to have more than 1,000 views and run between 1 and 10 minutes. This length was deemed the minimum and maximum amount of time for both the researchers to have content to analyze and viewers to retain relevant information.

Fifty videos were included in the study. Shungu and colleagues graded the videos using DISCERN, a previously validated tool that evaluates “quality of information and decision-making” (eg, content contains clear-cut goals, is relevant to patients, discusses bias and evaluates the pros and cons of treatment). The researchers also used the Patient Education Material Assessment Tool, or PEMAT, which is another validated tool that evaluates “understandability and actionability” (eg, content uses common language, uses visual aids and breaks actions into steps).

The findings, published in the Journal of the American Board of Family Medicine, showed that inter-rater reliability testing was consistent for the PEMAT (interclass correlation coefficient = 0.69) and DISCERN (interclass correlation coefficient = 0.85). The average DISCERN score for the videos was 40.24 points, with scores ranging from 21.5 points to 70 points out of a possible 80 points. Just 16% of the videos reached the tool’s quality threshold (54.4 points). Regarding PEMAT, the average score for the videos was 9.31 points, and scores ranged from 5.75 points to 12.5 points out of a possible 15 points. Only 28% of videos achieved the tool’s threshold (15 points). Less than half of the videos directly addressed racial disparities in prostate cancer and there was no difference in the quality of the video based on perceived race of the presenter.

“We were surprised at our finding that fewer than half of the videos targeting Black men discuss racial prostate cancer disparities,” Shungu said. “Informing Black men about racial prostate cancer disparities is recommended as a best practice by the United States Preventive Services Task Force and is essential information for Black men making a decision about screening.”

The researchers also reported that the quality of videos significantly increased after changes to the USPSTF prostate cancer screening recommendation. Before May 2012, when the most recent USPSTF recommendation advised against screening men aged 75 years and older for prostate cancer and the task force did not have enough evidence to make a recommendation for men younger than 75 years, the average DISCERN score was 39.95 points. Between May 2012 — when the USPSTF recommended against prostate-specific antigen-based screening for prostate cancer — and May 2018, the average score was 37.85 points. After May 2018, when the USPSTF recommended that men aged 55 to 69 years make their own decision on periodically undergoing prostate-specific antigen screening and against such screening in men aged older than 70 years, the average score was 48.74 points. The difference in scores remained significant even after researchers removed the DISCERN question about shared decision-making (37.7 points, 35.43 points, 45.79 points, respectfully; P = .042). The PEMAT scores remained consistent throughout the study.

The DISCERN scores closely align with other studies that have analyzed YouTube videos regarding prostate cancer screening among other populations, according to Shungu.

Collectively, the study results underscore the “important role that primary care physicians must play in educating Black men about prostate cancer risk and empowering them to make an informed decision about screening,” he said. “Physicians should empower their Black patients by informing them that the decision to undergo prostate cancer screening is a personal one.”

References:

Shungu N, et al. J Am Board Fam Med. 2021;doi:10.3122/jabfm.2021.04.200632.

USPSTF. Prostate cancer screening recommendations (2008). https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening-2008. Accessed Sept. 1, 2021.

USPSTF. Prostate cancer screening recommendations (2012). https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening-2012. Accessed Sept. 1, 2021.

USPSTF. Prostate cancer screening recommendations (2018). https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening. Accessed Sept. 1, 2021.