Radiology Is Underrepresented on Websites of Lung Cancer Screening Programs
Key findings
- This study examined radiology representation in the text, images, and videos on 257 websites publicizing lung cancer screening (LCS) services, and it assessed the multimedia and multilingual content of the sites
- Only 48% of the websites analyzed included references to radiologists or radiology as a specialty, and radiologists were identified by name on only 18% of websites and were represented in images or video on only 14%
- Websites most frequently mentioned only radiologists' role in interpreting CT scans (35%), with only 5% stating they provide follow-up and management recommendations
- 37% of LCS websites had no images, 74% included no videos, only 3% included any material written in languages other than English, and only 15% had first-person patient stories or narratives related to LCS
- Enhancing the profile of radiology on LCS websites should improve trust in screening programs as well as educate patients and the public about the specialty's key contributions to patient care
Only 1 in 20 eligible U.S. adults undergo lung cancer screening (LCS), according to a 2020 report in the Journal of the National Cancer Institute. Given the popularity of internet searches for health information, LCS programs need to maintain high-quality websites that provide information about the rationale for LCS, eligibility criteria, the logistics of screening, and the healthcare professionals involved.
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Efren J. Flores, MD, an officer of Radiology Community Health Improvement and Equity in the Department of Radiology at Massachusetts General Hospital, and colleagues have determined radiology is poorly represented on LCS program websites, reinforcing the longstanding lack of public awareness of the central roles of radiologists in health care. In Clinical Imaging, they also note limited multimedia and multilingual content of these websites, which might act as barriers to LCS participation for many individuals.
Methods
The team searched Google on September 15, 2018, using the terms "lung cancer screening," "low dose CT screening," and "lung screening." 257 unique U.S. LCS program websites were identified: 19% hosted by academic practices, 24% by community practices, 38% by hybrid practices, and 20% by "other" practices.
Each website was randomly assigned to and reviewed by one of nine thoracic radiologists with expertise in LCS.
Radiology Representation
Mentions of radiology and radiologists were low across metrics:
- Proportion of websites that mentioned radiologists or radiology as a specialty in text, images, or video—48%
- Mean percentage of sentences devoted to radiology as a percentage of total sentences—3% per site
- Proportion of sites that mentioned radiologists by name—18%
- Proportion of sites that represented radiologists in images or videos—14%
The sites most frequently mentioned only radiologists' role in interpreting low-dose CT scans (35%), and only 5% said they provide follow-up and management recommendations.
Other Content Issues
- Images—37% of sites had no images, and only 27% had more than one
- Videos—74% of sites had no videos, and only 4% had more than one
- Language—97% of sites were written only in English without supplemental material in any other language
- Accessibility—No site had materials specifically designed for people with impaired vision
- Patient engagement—Only 15% of sites included first-person patient narratives related to LCS
Relevance to Patient Care
Radiologists are essential to organizing, executing, and sustaining LCS programs. Enhancing the profile of radiology on LCS websites will help educate patients and the public about the specialty's key functions and improve trust in screening programs.
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