INTRODUCTION
Melanoma, the fifth most common and most lethal skin cancer globally, significantly contributes to cancer mortality.1,2 In 2023, estimated new cases are projected to surge to 97,610.2 Despite a higher incidence in non-Hispanic White populations, melanoma more adversely affects racially diverse groups due to later-stage diagnoses and advanced disease presentation.2,3 African American patients demonstrate a lower 5-year survival rate (69.8%) compared to Whites (93.1%).1,3
Among the evaluated videos, 71.43% (n = 30) were presented by medical personnel, while the remainder were personal narratives (z-score 3.7108, P<0.002). Non-Hispanic Whites were featured in 95.24% of the videos, significantly
overrepresented compared to all other racial/ethnic groups (z-score 7.2528, P<0.00001), as illustrated in Figure 1. Non-Hispanic White-centric videos averaged 101,501 views per video, while videos featuring racially and ethnically diverse individuals averaged 16,120 views per video (P<0.00463), as depicted in Figure 2.
Public health education often sidelines diverse racial and ethnic populations, exacerbating these disparities.3 The reliability of information on YouTube, particularly due to its lack of regulatory oversight has garnered concerns.3 This study assesses melanoma information on YouTube, emphasizing the representation of diverse racial and ethnic populations and underscoring the importance of comprehensive health information.
On March 23, 2023, a YouTube search for "What does melanoma look like" generated 56 English videos ranked by views. Inclusion criteria encompassed videos addressing melanoma with images of the condition. Videos lacking melanoma imaging (N=14) were excluded due to the inability to be evaluated for representation. The remaining 42 videos were reviewed based on (1) number of views, (2) depicted racial/ethnic group, and (3) presenter's medical credentials. Three independent reviewers, trained in data extraction, confirmed data accuracy, with discrepancies resolved through a majority vote.
Statistical analysis computed and compared the representation of racial/ethnic groups (non-Hispanic White, African American, Asian, Native American, and Hispanic) and average views using two-tailed Z-tests and T-tests, respectively. The proportion of videos made by medical professionals -- defined as board-certified physicians, nurses, nurse practitioners, and physician's assistants -- versus non-medical professionals were assessed using a two-tailed Z-test.
Among the evaluated videos, 71.43% (n = 30) were presented by medical personnel, while the remainder were personal narratives (z-score 3.7108, P<0.002). Non-Hispanic Whites were featured in 95.24% of the videos, significantly
overrepresented compared to all other racial/ethnic groups (z-score 7.2528, P<0.00001), as illustrated in Figure 1. Non-Hispanic White-centric videos averaged 101,501 views per video, while videos featuring racially and ethnically diverse individuals averaged 16,120 views per video (P<0.00463), as depicted in Figure 2.
