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

Abstract

Background Compared with White Americans, Black Americans have higher colon cancer mortality rates 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 increased awareness, Boseman’s death may have resulted in greater interest in colon cancer on the internet, particularly among Black Americans. Objective This study aims to quantify the impact of Chadwick Boseman’s death on web-based search interest in colon cancer and determine whether there was an increase in interest in regions of the United States with a greater proportion of Black Americans. Methods We conducted an infoveillance study using Google Trends (GT) and Wikipedia pageview analysis. Using an autoregressive integrated moving average algorithm, we forecasted the weekly relative search volume (RSV) for GT search topics and terms related to colon cancer that would have been expected had his death not occurred and compared it with observed RSV data. This analysis was also conducted for the number of page views on the Wikipedia page for colorectal cancer. We then delineated GT RSV data for the term colon cancer for states and metropolitan areas in the United States and determined how the RSV values for these regions correlated with the percentage of Black Americans in that region. Differences in these correlations before and after Boseman’s death were compared to determine whether there was a shift in the racial demographics of the individuals conducting the searches. Results The observed RSVs for the topics colorectal cancer and colon cancer screening increased by 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 3 months following Boseman’s death. Daily Wikipedia page view volume during the 2 months following Boseman’s death was on average 1979% (95% CI 1375%-2894%) greater than expected, and it was estimated that this represented 547,354 (95% CI 497,708-585,167) excess Wikipedia page views. Before Boseman’s death, there were negative correlations between the percentage of Black Americans living in a state or metropolitan area and the RSV for colon cancer in that area (r=−0.18 and r=−0.05, respectively). However, in the 2 weeks following his death, there were positive correlations between the RSV for colon cancer and the percentage of Black Americans per state and per metropolitan area (r=0.73 and r=0.33, respectively). These changes persisted for 4 months and were all statistically significant (P<.001). Conclusions There was a significant increase in web-based activity related to colon cancer following Chadwick Boseman’s death, particularly in areas with a higher proportion of Black Americans. This reflects a heightened public awareness that can be leveraged to further educate the public.

Public Interest and Behavior Change in the United States Regarding Colorectal Cancer Following the Death of Chadwick Boseman: Infodemiology Investigation of Internet Search Trends Nationally and in At-Risk Areas

“…Until recently, the impact of a public figure's disclosure of illness regarding CRC was unknown. In line with our own findings, one recently published study by Naik et al [38] examined internet search interests in CRC-related topics following Chadwick Boseman's death and found increases in searches on Google and Wikipedia comparable to our own. Moreover, the study found proportionally higher increases among areas with higher proportions of Black Americans, a novel and important finding that should be used to increase CRC education among this at-risk community.…”

The Black Panther, Masculinity Barriers to Medical Care, and Colorectal Cancer Screening Intention Among Unscreened American Indian/Alaska Native, Black, and White Men

“…A previous study ( 68 ) of the impact of Boseman's death on web-based search interest in CRC found that relative search volume (RSV) for the topics colorectal cancer and colon cancer screening increased by 598 and 707%, respectively, and were on average 121 and 256% greater than expected during the first 3 months following Boseman's death. The race or ethnicity of those conducting these searches could not be ascertained due to the infoveillance nature of the study; however, during the 2 weeks following Boseman's death, statistically significant positive correlations, which persisted for 4 months, were seen between the RSV for colon cancer and the percentage of Black Americans per state and per metropolitan area.…”

The Boseman Effect: A Missed Opportunity?

“…The decrease in screening was likely related to the fact that elective procedures were banned as the COVID-19 pandemic worsened in the United States around March 2020. Another study similarly showed a spike in colon cancer searches around Boseman’s death in late August 2020 [ 12 ]. However, in our study, search volume for “colon cancer” and “colonoscopy” returned to their pre-pandemic levels by April 2021, which is contrary to the influence celebrities have had in the past.…”

“…More recently, actor Chadwick Boseman died on August 28th, 2020, of colon cancer at the age of 43. While it may be too soon to see the long-term effects of Boseman’s death on colon cancer screening rates, recent research has shown that interest in colon cancer increased surrounding his death, particularly among Black Americans [ 12 ]. However, it is unclear if this interest in the disease translated into an interest in colon cancer screening and how long that effect might have lasted.…”