11 The BRFSS is one of the largest annual telephone health survey database systems in the world. Prevalence data about breast cancer screening (mammography and breast self-examination), cervical cancer screening (Pap smear), colorectal cancer screening (faecal occult blood test (FOBT), colonoscopy), and prostate cancer screening using prostate screening antigen (PSA) test were all obtained from the 2012 BRFSS database. Specifically, we examined (1) the correlation between 2012 Google Trends and self-reported breast, cervical, colorectal and prostate cancer screening in the 2012 BRFSS and (2) interest in possible new and developing screening modalities and preparations not currently captured in existing surveillance systems since 2004. Here, we examined the utility of Google Trends relative to the BRFSS, focusing on cancer screening. Depending on its utility, Google Trends may complement existing surveillance systems that monitor screening use. 9, 10 However, the value of Google Trends in illuminating search trends reflecting interest in cancer screening and related topics has not yet been examined. Both Google and Yahoo! search engines have been used to analyse different types of search queries, for example about cancer incidence, 5 cancer mortality, 5 kidney stones, 6 non-cigarette tobacco use, 7 sexually transmitted infections, 8 and flu trends. Google Trends is a keyword research tool that provides near real-time trend data regarding interest as operationalised by internet search volume. Recent technological advances in data acquisition, such as Google Trends, may allow for more timely data collection to learn about trends in interest in various health-related topics, including cancer screening. As a result, population-based prevalence of newer screening methods is unknown. Other limitations of traditional surveillance approaches include the failure to capture new and emerging screening modalities (eg, virtual colonoscopy for colorectal cancer, MRI for breast cancer detection, or low-dose spiral CT for lung cancer screening among persons at high risk for lung cancer) especially when use is still low. In addition, these older methods require participation of a large study population to estimate screening use accurately, they rely on self-report resulting in potential recall bias and, for the BRFSS and HINTS, participants include only persons with landline telephones and, recently, mobile phones and a mailing address to complete a self-administered questionnaire, leaving the door open for potential selection bias. Traditional surveillance approaches are expensive to maintain due to their use of survey interview methods for data collection and the time required to aggregate the data. These traditional surveillance systems are ill equipped to deal with a rapidly changing digital world with a need for timely health data for public health and medical professionals, policymakers, and the public who influence policy choices. 4 These databases have been invaluable in identifying determinants of screening use and describing trends and disparities over time. There are several surveillance systems that monitor self-reported cancer screening utilisation, including the Behavioral Risk Factor Surveillance System (BRFSS), 1, 2 the National Health Interview Survey (NHIS), 3 and the Health Information National Trends Survey (HINTS). Also, Google Trends data represent only searches done using Google.Ĭancer screening is a cornerstone of public health aimed at promoting early diagnosis and, in some instances, prevention of cancer.
Google Trends data are anonymous, which limits its utility in examining specific subpopulations and disparities among populations. The utility of Google Trends to help evaluate interventions depends on the area where the intervention is implemented, since data is only available for states and selected metropolitan areas, limiting its use in rural areas or areas with a low search volume. Internet searches can be an important source for generating hypotheses about public awareness and interest in cancer screening, evaluating changes in information seeking after targeted interventions or media coverage, and directing new communication campaigns to explain the evidence base for screening tests.Īn evaluation that occurs almost immediately after an intervention may inform policymakers of the associated costs and benefits when there is still interest to make modifications to, or expand, any policy changes. Google Trends data help identify developing interests in new cancer screening tests or related aspects of specific screening tests.
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