If you have a family history of prostate cancer (PCa), or you’ve been exposed to environmental toxins, or you’re a member of an ethnic group with a vulnerability for PCa, your doctor should discuss guidelines for annual PSA screening. annually screened by a PSA blood test. He or she may have provide you with brochures or printouts containing educational information about PCa risks and the importance of early detection. And, if you’re like most health-conscious men, you may decide to do your own research.

In pre-internet days, you might have gone to your local library for resources. If you were of a scholarly mindset and lived near a university medical center, you might even have been able to access the latest research. The downside of medical journals is their scientific terminology, much of which can discourage lay readers. The upside, though, is that the published research papers you find have been peer reviewed and approved, so their contents are authoritative. You can trust their accuracy and validity.

These days, however, you don’t hop in the car and spend a day browsing stacks of publications. PCa information is right at your fingertips, via your keyboard or smartphone. But don’t trust everything you find.

Caveat emptor

If you begin seeking enlightenment on the internet, there’s a principle that’s as valid today as it was in its original Latin: caveat emptor. It means “Let the buyer beware.” When you access your search engine to jump into the PCa world, what you find on social media may not have been professionally reviewed.

In the social media world, “peer review” means people like you, who are your peers. They are not necessarily knowledgeable. Instead, they are searching through the same haystacks as you. Finding the needle of truth can be tricky.

That’s the message underlying a 2022 peer reviewed research paper on the quality of PCa information available on two popular social media platforms. The title of the study is “Accuracy of Prostate Cancer Screening Recommendations for High-Risk Populations on YouTube.”^[i] The authors were from two New York academic medical centers, Albert Einstein College of Medicine and New York University.

Three reviewers analyzed the 50 top-viewed videos on each platform that focused on PCa screening from YouTube and TikTok. They used validated criteria to assess the quality of consumer health information. Did the videos represent racial/ethnic diversity? Did they accurately convey current guidelines for higher risk groups? Did they meet quality criteria for consumer information? Misinformation (or “fake news”) was determined by comparing video content with American Urological Association and National Comprehensive Cancer Network guidelines.

The researchers found that populations considered at higher risk for PCa incidence and mortality (i.e., Black and Hispanic) were not adequately represented in YouTube and TikTok videos. Furthermore, the authors write, “A total of 98% of YT videos and 100% of TK videos had low- to moderate-quality consumer health information, and 88% of YT videos and 100% of TK videos had moderate to high levels of misinformation based on screening guidelines.”

Out of the total 100 videos analyzed, there were none that contained both high quality and accurate information! Between YouTube and TikTok, YouTube offered better overall quality:

	YouTube	TikTok
PSA testing	96%	14%
Specific recommendations for patients with PCa family history	50%	6%
Age-specific recommendations	54%	10%
Digital rectal exam	34%	14%
MRI screening	12%	0%
Prostate biopsy	10%	0%
Genomic testing	10%	0%

It’s sad that populations at higher PCa risk are unlikely to get the information they need to make wise decisions about PCa screening. It’s particularly so for TikTok viewers—a platform that now appears to have more users than YouTube—because there is less meaningful education in those videos.

Every man needs correct input in order to make correct PCa screening decisions. The internet is a powerful source of information, as well as a source of “fake news.” I can only wonder how many men are missing the right guidelines, and don’t even know it? If they are at higher risk for PCa and don’t know they should have an annual PSA test, they may miss a window for early detection—and ultimately end up with aggressive, incurable PCa. Let the buyer beware indeed!

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

[i] Abramson, M, Feiertag, N, Javidi, D, Babar, M, Loeb, S, Watts, K. Accuracy of prostate cancer screening recommendations for high-risk populations on YouTube and TikTok. BJUI Compass. 2022.