"Clicks, likes, shares and comments" a systematic review of breast cancer screening discourse in social media

BackgroundUnsatisfactory participation rate at population based organised breast cancer screening is a long standing problem. Social media, with 3.2 billion users in 2019, is potentially an important site of breast cancer related discourse. Determining whether these platforms might be used as channels by screening providers to reach under-screened women may have considerable public health significance.ObjectivesBy systematically reviewing original research studies on breast cancer related social media discourse, we had two aims: first, to assess the volume, participants and content of breast screening social media communication and second, to find out whether social media can be used by screening organisers as a channel of patient education.MethodsWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). After searching PubMed, ScienceDirect, Web of Science, Springer and Ebsco, 17 studies were found that met our criteria. A systematic narrative framework was used for data synthesis. Owing to the high degree of heterogeneity in social media channels, outcomes and measurement included in this study, a meta-analytic approach was not appropriate.ResultsThe volume of breast cancer related social media discourse is considerable. The majority of participants are lay individuals as opposed to healthcare professionals or advocacy groups. The lay misunderstandings surrounding the harms and benefits of mammography is well mirrored in the content of social media discourse. Although there is criticism, breast cancer screening sentiment on the social media ranges from the neutral to the positive. Social media is suitable for offering peer emotional support for potential participants.ConclusionDedicated breast screening websites operated by screening organisers would ensure much needed quality controlled information and also provide space for reliable question and answer forums, the sharing of personal experience and the provision of peer and professional support.

背景 基于人群的规范化乳腺癌筛查参与率偏低是长期存在的公共卫生难题。2019年全球社交媒体用户达32亿，其或为乳腺癌相关话题讨论的重要阵地。明确此类平台能否被筛查服务提供方用作触达未筛查女性的渠道，具备重要的公共卫生价值。
研究目的 本研究通过系统回顾乳腺癌相关社交媒体话语的原创研究，达成两大目标：其一，评估乳腺癌筛查相关社交媒体传播的规模、参与主体与内容特征；其二，明确筛查组织方能否借助社交媒体开展患者教育。
研究方法 本研究遵循《系统评价与元分析首选报告规范》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA）。通过检索PubMed、ScienceDirect、Web of Science、Springer及Ebsco数据库，最终纳入符合纳入标准的17项研究。研究采用系统性叙事框架开展数据合成。鉴于本研究纳入的社交媒体渠道、结局指标与测量方式存在高度异质性，故不适合采用元分析方法。
研究结果 乳腺癌相关社交媒体话语的讨论规模可观。参与主体以普通民众为主，而非医疗专业人员或倡导组织。民众对乳腺钼靶检查的利弊认知误区，在社交媒体话语内容中得到充分体现。尽管存在批评声音，但社交媒体上的乳腺癌筛查舆情整体处于中性至积极区间。社交媒体可为潜在筛查人群提供同伴情感支持。
研究结论 由筛查组织方运营的专属乳腺癌筛查网站，既能提供亟需的质量管控信息，也可搭建可靠的问答论坛、个人经验分享平台，并提供同伴与专业支持服务。