Evaluating Quality, Guideline Accuracy, and Racial/Ethnic Representation of YouTube Videos on Colon Cancer Screening.

Colon cancer is the third leading cause of cancer death in the United States and disproportionately affects Black individuals. Screening guidelines were recently lowered to begin at age 45, but it remains unclear whether widely accessed online health sources such as YouTube reflect these updates and represent high-risk racial/ethnic groups. This cross-sectional study analyzed the top 50 English-language YouTube videos (< 12 min) on “colon cancer screening” accessed in August 2024. Three reviewers assessed video quality using DISCERN and the Patient Education Materials Assessment Tool (PEMAT). Accuracy was rated on a 5-point Likert scale against the 2024 American Cancer Society and 2021 U.S. Preventive Services Task Force guidelines. Race/ethnicity of individuals in videos was subjectively categorized. The top 25 (T25) most-viewed videos were compared with the bottom 25 (B25) using Student t-tests and Fisher’s exact test. Compared with B25 videos, T25 were more understandable (Mean PEMAT: 69.0 vs. 71.5, p < 0.04) and actionable (Mean PEMAT: 52.5 vs. 58.5, p = 0.23) but less comprehensive in discussing risks and benefits of treatment. Both groups demonstrated high guideline concordance (ACS and USPSTF Likert > 4). Representation of Black and Hispanic individuals remained limited and did not differ significantly by popularity. The most popular YouTube videos on colon cancer screening are guideline-concordant, understandable, and actionable, but lack comprehensiveness on screening options, and sufficient representation of high-risk racial/ethnic groups. More comprehensive and targeted educational outreach efforts are needed to promote colon cancer screening, especially in high-risk racial/ethnic groups.