Misinformation is defined as “false or inaccurate information regardless of intentional authorship.” Health misinformation is widespread on the Internet, and this can have a devastating effect on people’s health and well-being. Perhaps there is no disease state in which scientifically valid information is more necessary than in the management of cancer as timely, accurate information can save lives. Yet, the extent of misinformation on theInternet involving cancer remains undetermined.

Researchers from Moody College School of Communication and the University of Texas at Austin set out to quantify and describe the incidence of misinformation about breast cancer (BC) on Pinterest, a social media source viewed by about 322 million people every month. Women constitute about 70% of the users, with over 40% of U.S. women having visited the site. Health-related subjects are one of the top-three areas discussed on Pinterest. Pinterest employs pins, which are graphics that can be searched and saved (bookmarked) for future reference by Pinterest users. The investigators expressed concern that visual misinformation may have a more long-lasting effect as it more easily affects viewers’ recall ability.

Misinformation about BC was broken down into six types: contraindicated (i.e., information from reliable sources recommend against the advice promoted in a pin), exaggerated (i.e., conclusions in a pin are overblown based on corroborated reliable sources), inaccurate (i.e., reliable information refutes a pin’s claim and proves it false), no evidence (i.e., there are no reliable sources to support the claims made in a pin), omission (i.e., a pin claim leaves out crucial information thereby making the pin’s claim false), and outdated (i.e., the information provided in a pin’s claim is no longer accurate). Investigators also gathered information on the phase of the pin claim, i.e. whether it involved information on prevention, treatment, or both. They also searched for evidence of conspiracy theories.

The authors sought out to determine the frequency of misinformation within posts as well as the whether the misinformation took the form of text only, image only, or both; the sources linked to the posts; the type and phase of misinformation; the content or focus of the pin (e.g. dietary supplements, food, or BC screening); and the presence of conspiracy theories.

A total of 797 pins were analyzed using ParseHub, a software program for web scraping or data extraction that gathers information from the web. Six searches of the terms “breast cancer” or “breast + cancer” were conducted on the Pinterest website during November 2018. Information on links to the pins was also collected. Deductive coding (which focused on whether the misinformation involved prevention, treatment or both phases, type of websites that the pin linked to, misinformation in the image, image open cell, text or text open cell, and conspiracy theories) and inductive coding (which stressed misinformation type and misinformation content) were utilized.

Of the 797 pins, 22.3% (178 pins) made a claim involving prevention or treatment of BC and were subject to further analysis. These claims were fact checked against reputable BC information sources, which included Memorial Sloan Kettering Cancer Center, the World Cancer Research Fund, the National Cancer Institute, BreastCancer.org, Susan G. Komen, and published academic papers. Only one claim made on the pin needed to be false for the pin to be labeled as containing “misinformation.”

Investigators found that of the pins whose claims were analyzed further, 51.1% contained misinformation or 11.4% of the overall sample. Almost half of the misinformation involved fraudulent information in both the pin’s image and its text, while 28.6% involved misinformation in the image only and almost one-quarter involved misinformation in the pin’s text only. Almost three-quarters of these pins with misinformation linked to blogs as their reference source.

The type of misinformation varied with 54.9% representing exaggerated claims (e.g., anticancer or preventative effects of dietary supplements or foods), 18.7% involved a lack of evidence (e.g., antiperspirants are linked to BC), 16.5% contained inaccurate information (e.g., safety and accuracy of mammograms, lack of risk with bioidentical hormones compared with synthetic hormones, and mischaracterization of BC stage parameters such as tumor size), 4.4% included outdated information (e.g., information from old mammogram screening guidelines), and 2.2% each contained either contraindicated information (e.g., advocated for the use of colloidal silver or turmeric) and errors of omission (e.g., did not adequately describe warning signs of BC).

When examining the phase of misinformation, 24.2% involved misinformation on both prevention and treatment, 34.1% pertained to misinformation on prevention, and 41.8% provided misinformation on treatments. The content of the misinformation most commonly involved the role of food in both prevention and causation of BC (39.6%), vitamin/minerals/herbs or supplements (19.8%), or environmental causes of BC (9.9%). Only 4% of pins contained conspiracy theories, which focused on the alleged withholding of information by the government on BC treatments or a coverup fueled by profit motives of the pharmaceutical industry or research organizations against some already withheld discovered natural cure.

Patient education is an integral part of a pharmacist’s professional responsibilities. It is imperative that pharmacists understand the sources and types of misinformation that their patients are reading, especially on topics as important as BC. This study provides insight for pharmacists who are on the front lines combating health misinformation.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

« Click here to return to Breast Cancer Update.