Internet Interest in Colon Cancer Following the Death of Chadwick Boseman: Infoveillance Study (Preprint)

Abstract

BACKGROUND Compared to White Americans, Black Americans have greater incidence and mortality rates from colon cancer, but lower up-to-date screening rates. Chadwick Boseman was a prominent Black American actor who died of colon cancer on August 28, 2020. As announcements of celebrity diagnoses often result in an increased awareness of particular conditions, Boseman’s death may have resulted in greater online interest in colon cancer. OBJECTIVE The objective of this study was to quantify the impact Chadwick Boseman’s death on online search interest in colon cancer, and thereby identify an opportunity for healthcare providers to educate the public and advocate for higher risk groups. METHODS We used Google Trends (GT) and Wikipedia pageview analysis to assess the change in online activity related to colon cancer in the United States from two years prior to Chadwick’s death to three months following the announcement of his death. We used two of GT search topics (“colorectal cancer” and “colon cancer screening”) and fifteen search terms related to colon cancer screening, symptoms, diagnosis and risk factors. We forecasted what RSVs and number of pageviews would be expected if his death had not occurred, and compared this to what was observed. The forecasts were generated with 95% bootstrapped confidence intervals (CIs) using the ARIMA algorithm in R software. RESULTS GT’s observed RSVs for the topics “colorectal cancer” and “colon cancer screening” increased by as much as 598% and 707%, respectively, and were on average 121% (95% CI, 72%-193%) and 256% (95% CI, 35%-814%) greater than expected during the first three months following Boseman’s death. Ten out of fifteen search terms had mean observed RSVs significantly higher than expected within the first and second month following Boseman’s death. Three of the fifteen search terms (“colon cancer signs”, “colon cancer survival” and “colon cancer symptoms”) remained significantly greater than expected within the third month following August 28, 2020. Daily Wikipedia pageview volume during the two months following Boseman’s death was on average 1,979% (95% CI, 1,375%-2,894%) greater than expected. Altogether, it is estimated that this represented 547,354 (95% CI, 497,708-585,167) excess Wikipedia pageviews beyond what would be expected if Boseman’s death had not occurred. CONCLUSIONS There has been a significant increase in online activity related to colon cancer following Chadwick Boseman’s death. This reflects a heightened public awareness that can be leveraged to further educate the public, including the high-risk Black American subgroup. The magnitude and duration of increased Google searches and Wikipedia pageviews following Boseman’s death is unprecedented in the literature and future research will reveal if this translates to improved screening and detection rates for colon cancer.