Flagged as False: Can Social Media Warnings Curb Cancer Misinformation?

By: Megan Brooks

From: medscape.com

False cancer treatment claims continue to circulate widely on social media. Although often shared by well meaning friends, family members, and caregivers seeking to offer hope or help, a growing body of evidence indicates that cancer misinformation can cause physical or emotional harm, even compromise survival when patients pursue unproven therapies.

What can be done to curb the spread of cancer misinformation online?

In a recent study, researchers found that simple social cue prompts — messages indicating that other users have flagged a post as false and potentially harmful — significantly increased users’ willingness to intervene and reduced their willingness to share false cancer treatment claims. This finding suggests a scalable strategy to curb harmful content.

False cancer information on social media is a “big problem,” explained Eric Singhi, MD, thoracic medical oncologist in Houston, with the social media presence @lungoncdoc.

Although quantifying the scope of the problem is a challenge, recent studies have estimated anywhere from about one third to 80% cancer-related posts on social media contain misinformation. Posts touting fake cures or making misleading treatment claims tend to spread fast because they’re emotionally charged, simple, and often packaged as personal testimony or a “suppressed secret,” said Singhi, who was not involved in the current study.

Additionally, Singhi noted, “fear, urgency, and real side effects from legitimate therapy make people vulnerable to what sound like easy alternatives.”

Singhi has seen the real-world harms of online cancer misinformation — patients who have delayed or stopped effective therapy, tried unproven regimens, encountered dangerous supplement interactions, and been exploited financially.

“The harm isn’t usually one viral post, it’s the quiet detour of delay, doubt, and missed windows where evidence-based treatments work best,” he said.

Can Flagging False Info Help?

For their study, Allison Lazard, PhD, and colleagues at the University of North Carolina at Chapel Hill designed an intervention to encourage people to flag or report cancer misinformation online.

The team recruited 1051 men and women adults; 38% were close to someone who had cancer, 25% were cancer caregivers, and 5% reported a prior cancer diagnosis.

Participants were randomly allocated to view cancer treatment misinformation social media posts with social cue prompts (warnings, nudges, or labels) and a flagging policy (intervention) or no prompts or policy (control).

The misinformation posts promoted soursop (guyabano) as a natural cure for cancer that trumps chemotherapy and anti-angiogenic vegetables as a cure for metastatic breast cancer.

Both posts were created to mirror the style and content of actual posts found on Instagram, using commonly shared cancer treatment misinformation themes, such as natural cures, and persuasive strategies common to health misinformation, such as personal narratives and distrust of the government or pharmaceutical companies.

In the intervention group, prompts stated that the post had been flagged as false and potentially harmful by other users and explained that posts would be removed for review if flagged by a threshold number of people. Participants were asked about their willingness to intervene by flagging, muting, or disliking or to share a post by liking or commenting.

The results were clear. Participants exposed to prompts were significantly more willing to flag, dislike, or mute a false post and less willing to share it than peers who did not see prompts (25% vs 13%). Intervening was also much more likely when a lot of people had already intervened. People who intervened or didn’t share misinformation often cited concerns about accuracy or the potential that the information would cause harm to patients.

Overall, the study suggests that prompts can help reduce sharing of cancer misinformation on social media platforms and encourage people to intervene, especially when a post has been flagged by many others.

Curbing cancer misinformation on social media platforms using this approach is a “promising, pragmatic step, but not a cure-all,” Singhi said.

Shruti Patel, MD , oncologist at the Stanford Medicine in Stanford, California, agreed that flagging information on social media platforms can play a “major role” in reshaping reach and amplification, but she is “not optimistic that platforms will meaningfully self-police unless there is external pressure.”

Stacy Loeb, MD, urologist and public health professor at NYU Langone Health in New York City, explained that limiting or stopping the spread of online cancer misinformation requires multi-factorial solutions and buy-in from many stakeholders, including content creators, clinicians, scientists, professional societies, community organizations, educators, social media platforms, and governments.

Loeb suggested that oncologists can help by providing patients with an “information prescription” with recommended sources of evidence-based online information that has been vetted or written by clinicians and cancer organizations.

“Realistically,” added Singhi, “oncologists and cancer organizations can’t fact-check the entire internet, but we can be strategic together: we can ‘prebunk,’ not just debunk by teaching patients and their loved ones to recognize those red flags.” Red flags can include claims of a “miracle cure,” “100% success,” “no side effects,” or products that suggest clinicians are hiding information or cures from patients, Singhi said.

Patel, who has seen the real-world consequences of cancer misinformation, suggested oncologists proactively ask what patients have seen online and create a judgment-free space to discuss it.

“Our patients are smart,” said Patel. “Talk to them about the evidence or lack thereof. Ask questions like are there any conflicts of interest? Is it selling something? Is it too good to be true?”