Most online prostate cancer content lacks Black and Latinx representation, study reports

Reviewed by Emily Henderson, B.Sc.Feb 4 2022

Despite their higher risks of advanced prostate cancer, Black and Latinx men are under-represented on websites and in online videos providing information and education regarding prostate cancer, reports a study in The Journal of Urology^®, an official journal of the American Urological Association (AUA). The journal is published in the Lippincott portfolio by Wolters Kluwer.

Online media have significant potential for public education and combating health disparities. However, most online prostate cancer content lacks racial/ethnic diversity and is not readily understandable for lay health consumers."

Stacy Loeb, MD, MSc, PhD (Hon), Lead Author, New York University Langone Health

Content lacks Black and Latinx representation; issues with quality and readability

The study is one of the first to examine racial/ethnic representation and quality of online prostate cancer information. Representation is critical as Black men have the highest risk of and mortality from prostate cancer, while Latinx men are more likely to be diagnosed at a later stage and less likely to receive guideline-recommended care for prostate cancer.

Dr. Loeb and colleagues searched Google and YouTube to identify websites and videos providing prostate cancer information. The analysis focused on resources depicting people – human or animated – who were then classified by their perceived race/ethnicity through a consensus process with diverse community stakeholders. The study involved researchers from nine institutions across the United States.

The analysis included a total of 81 websites and 127 YouTube videos about prostate cancer. Of approximately 1,500 people pictured in these resources, the perceived racial distribution was White in 55%, Black in nine percent, and Asian in eight percent. (For 28% of people depicted, race was classified as unknown or undetermined.) Perceived ethnicity was Latinx in just one percent of people in online content.

Overall, 37% of websites and 24% of videos had perceived representation of Black adults. Latinx people were depicted in just 10 percent of websites and 5.5 percent of videos.

The researchers used validated tools to evaluate the quality and readability of each online resource. "Few websites or videos had Black or Latinx representation and high-quality, understandable, and actionable information," Dr. Loeb and coauthors write. None of the resources depicting Black or Latinx people were at a recommended reading level for consumer health information.

Only 27% of websites and 17% of videos discussed racial/ethnic disparities in prostate cancer risk. The researchers note that many of the resources reviewed – regardless of Black or Latinx representation – had problems in terms of quality, misinformation, and commercial bias.

Black and Latinx men are also more likely to have distrust of the healthcare system and of physicians, and more likely to use online networks such as YouTube. Dr. Loeb and coauthors conclude: "To leverage the full potential of these large online networks, it is important that a greater proportion of websites and videos include representation of racial and ethnic diversity."