Colorectal cancer conversations on Twitter: A content analysis of global perceptions and outreach efforts.

35 Background: Screening is highly effective at reducing colorectal cancer (CRC) mortality. Social media is extensively used to communicate about cancer care, yet little is known about the role of these online platforms in promoting CRC screening and early diagnosis. This study tracked Twitter discussions about CRC and characterized participating users to better understand public communication and perceptions of CRC on social media. Methods: Tweets containing references to CRC were collected from January 2020 to April 2021 using Twitter’s Application Programming Interface. Account metadata was used to predict user demographic information and classify users as either organizations, individuals, or influencers. Influencers represent high-impact users, defined by sizeable follower counts or verified Twitter status. Latent Dirichlet Allocation, a natural language processing model, was used to identify observed topics of discussion in the collected tweets. Results: There were 72,229 unique CRC-related tweets by 31,170 users. Tweets reached a daily maximum after Chadwick Boseman, a well-known American actor, died from CRC. Individuals accounted for the majority of users (62.8%); organizations (35.2%); influencers (2%). Influencers made the most median impressions (35,853 impressions). Tweets contained the following topics: bereavement (27.9%), appeals for early detection (19.4%), research (14.0%), National Colorectal Cancer Awareness Month (NCCAM) (13.7%), screening access (12.5%), and risk factors (12.4%). Tweets referencing bereavement had the most user engagement. Links to clinical trial enrollment information were the least shared type of embedded content (0.3%). Conclusions: Discussions about CRC largely focused on bereavement and early detection. Online coverage of NCCAM, personal experiences, and celebrity deaths related to CRC effectively stimulated goal-oriented tweets about early detection. Our findings suggest that Twitter may be a suitable platform for promoting and communicating future public health recommendations about CRC.