Lung cancer screening on YouTube: Difficulty of finding balanced information.

162 Background: Lung cancer (LC) is the leading cause of cancer mortality in the US, the 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 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. Methods: 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 minutes, duplicates and videos in a language other than English were excluded. This method yielded 124 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. Results: 124 videos had a cumulative 262753 views. 38.7% of the videos included no mention of CMS guidelines. Only 30% included any mention of the risks associated with screening; 14% mentioned false positives, 12% radiation; 4% anxiety associated with screening though 92% of all videos sampled were intended for patients. 91% of videos explained the benefits associated with cancer screening however, only 26% explained the actual process of screening. The majority of videos were created by medical institutions (66%). No videos sampled included false information. Conclusions: While most videos highlighted the benefits of LC screening, YouTube can’t serve as a replacement for SDM visits due to inadequate discussion of risks of screening. A substantially low number of videos (30%) discussed the risks of lung cancer screening. Given the high rate of false positives, radiation and anxiety associated with screening, patients need to be made aware of these risks so they can make an informed decision.