EP401 - Accuracy and Quality of Spanish-Language YouTube Videos on Colon Cancer Screening

Purpose/Background: Colorectal cancer is the second leading cause of cancer death worldwide, and increased incidence in younger populations led to lowered screening age from 50 to 45 years. Despite Spanish being the second most spoken language in the United States, the quality of Spanish-language online video content remains unknown. Since 2021, YouTube's health source shelf has highlighted verified health content. This study is the first to compare the quality and accuracy of Spanish-language colorectal cancer screening YouTube videos from the health source shelf and general search results.

Methods/Interventions: Youtube was queried in a private, cache-cleared browser using the search terms "detección del cáncer de colon," "cribado del cáncer de colon," "colonoscopia," and "prueba FIT." All health shelf videos and the top 15 search videos were screened. Eligible videos were Spanish-language, published after 2020 and < 12 minutes. YouTube Shorts, duplicates, and wordless animations were excluded. Four reviewers independently analyzed videos using DISCERN (>52), PEMAT (≥75%), GQS (>4), and a 5-point Likert scale (>4) as cutoffs for high quality or accuracy relative to the 2024 American College of Surgeons (ACS), 2021 United States Preventive Services Task Force (USPSTF), and 2021 United States Multi-Society Task Force (MSTF) guidelines. Sign, Chi-square, Wilcoxon signed-rank, and t-tests evaluated score distributions and video quality between health shelf and regular results. Normalized GQS and Likert scores were analyzed across sources using Kruskal-Wallis tests.

Results/Outcomes: After exclusion, thirty-five Spanish-language colorectal cancer screening videos (14 health shelf, 21 regular search) were analyzed. Videos averaged 145,912 views and were most commonly produced in Spain (34%), the United States (29%), and Mexico (26%). Overall quality was moderate (mean DISCERN 44; PEMAT understandability 71%, actionability 62%; GQS 3.29), with moderate accuracy (ACS 3.28; USPSTF 3.14; MSTF 3.14). DISCERN, GQS, and Likert scores were significantly lower (p <.001, p<.001, all p<.05), while PEMAT scores were higher (both p<.001). No significant quality differences were found between health shelf and regular videos (DISCERN 45 vs. 43, p=0.65), though health shelf videos had slightly lower PEMAT understandability (68% vs. 73%, p< 0.50), actionability (61% vs. 63%, p< 0.80), and GQS (3.29 vs. 3.30, p< 0.90), but higher accuracy across ACS (3.6 vs. 3.0, p< 0.20), USPSTF (3.6 vs. 2.8, p< 0.06), vs. MSTF (3.6 vs. 2.8, p< 0.07) guidelines.

Conclusion/Discussion: Spanish-language YouTube videos on colorectal cancer screening are of moderate quality and accuracy. Verified sources from health shelf were more accurate but not more patient-centered. Improving accessible, high-quality Spanish-language content is needed to reduce disparities in screening education and outcomes.

Quality Metrics of Spanish YouTube Video Sources by Source
Compares all 4 quality metrics (DISCERN, PEMAT Understandability and Actionability, GQS) of videos from two sources
Accuracy of Spanish YouTube Videos by Source
Compares the accuracy of the videos from both sources to ACS, USPSTF, and MSTF guidelines