Combatting the cancer misinformation epidemic: navigating the truth in the age of social media

Social media remains a dominant force in today's society, impacting nearly every aspect of daily life and shaping how information is shared and consumed. Unfortunately, for individuals wishing to improve their knowledge on various topics, online platforms may not be the place to seek trustworthy information. These sites and social media platforms are commonly seen as a vessel for relaying quality health information, which can be the case in many instances. However, social media may not be the most reliable for enhancing someone's knowledge about health information. Individuals turn to social media for health information, but this may not always be helpful, because health information on social media is often inaccurate. Cancer misinformation is very prevalent in all aspects of life, regardless of age, gender, or specific diagnoses. Because it is very easy for patients with cancer and caregivers to look up cancer information on social media, it is important to understand how they perceive misleading and inaccurate information they view online.. Through the Cancer misInformation Research among Caregivers and patiEnts (CIRCLE) Study, we investigated how sociodemographics, cancer factors, and conspiratorial thinking are associated with participants' self report of cancer misinformation exposure on social media. Participants were eligible for the study if they were a caregiver for a patient with cancer and over the age of 18, or if they had been diagnosed with cancer and were currently between the ages of 15-39 for patients. A total of 21 individuals participated, and we found that most participants (57.1%, n=12) encountering cancer-related misinformation on social media were female (75%, n=9), Non-Hispanic White (91.7%, n=11), and primarily patients (91.7%, n=11) rather than caregivers. Of patients who had viewed misinformation, 25% were diagnosed before age 30. Those who were diagnosed with carcinomas, the most common cancer type, encountered the most misinformation about treatments and nutrition. Facebook and Instagram were the leading sources of misinformation, likely because they are the most common platforms of use. These findings highlight the importance of understanding why misinformation spreads on social media and how to limit its impact on vulnerable populations.

COMBATTING THE CANCER MISINFORMATION EPIDEMIC: NAVIGATING THE TRUTH IN THE AGE OF SOCIAL MEDIA by Jade Picco A Senior Honors Thesis Submitted to the Faculty of Utah In Partial Fulfillment of the Requirements for the Honors Degree in Bachelor of Science In Nursing Approved: ________ ___ ____ Melody Krahulec, DNP, MS, RN Chair, Department of Nursing Echo Warner, PhD, MPH Thesis Faculty Supervisor __ ________ Lauri Linder, PhD, APRN, CPON, FAAN, FAPHON Honors Faculty Advisor _____________________________ Monisha Pasupathi, PhD Dean, Honors College August 2025 ABSTRACT Social media remains a dominant force in today’s society, impacting nearly every aspect of daily life and shaping how information is shared and consumed. Unfortunately, for individuals wishing to improve their knowledge on various topics, online platforms may not be the place to seek trustworthy information. These sites and social media platforms are commonly seen as a vessel for relaying quality health information, which can be the case in many instances. However, social media may not be the most reliable for enhancing someone’s knowledge about health information. Individuals turn to social media for health information, but this may not always be helpful, because health information on social media is often inaccurate. Cancer misinformation is very prevalent in all aspects of life, regardless of age, gender, or specific diagnoses. Because it is very easy for patients with cancer and caregivers to look up cancer information on social media, it is important to understand how they perceive misleading and inaccurate information they view online.. Through the Cancer misInformation Research among Caregivers and patiEnts (CIRCLE) Study, we investigated how sociodemographics, cancer factors, and conspiratorial thinking are associated with participants' self report of cancer misinformation exposure on social media. Participants were eligible for the study if they were a caregiver for a patient with cancer and over the age of 18, or if they had been diagnosed with cancer and were currently between the ages of 15-39 for patients. A total of 21 individuals participated, and we found that most participants (57.1%, n=12) encountering cancer-related misinformation on social media were female (75%, n=9), Non-Hispanic White (91.7%, n=11), and primarily patients (91.7%, n=11) rather than caregivers. Of patients who had viewed misinformation, 25% were diagnosed before age 30. Those who were diagnosed with carcinomas, the most common cancer type, encountered the most misinformation about treatments and nutrition. Facebook and Instagram were the leading sources of misinformation, likely because they are the most common platforms of use. These findings highlight the importance of understanding why misinformation spreads on social media and how to limit its impact on vulnerable populations. TABLE OF CONTENTS INTRODUCTION​ 1 METHODS​ ​ 2 RESULTS​ 5​ DISCUSSION​​ 8 CONCLUSION​ 12 REFERENCES​ 14 1 INTRODUCTION Many individuals may have felt deceived and betrayed upon discovering they were misled by false information shared on social media. This information is referred to as health misinformation, and it may lead to confusion and misunderstanding. Unfortunately, some individuals wishing to seek information about specific health topics, like cancer, can be met with conflicting and misleading information online, which can hinder their ability to navigate health decisions effectively. Additionally, conspiracy theories found online through social media platforms increase the complexity of health information online and often lead to harmful consequences, such as ending treatment or avoiding certain resources (Marques et al., 2022). Conspiracy theories online can create anxiety for individuals and foster distrust in healthcare providers, which can promote ineffective or dangerous alternatives. Exposure to misinformation can harbor feelings of fear and confusion, making it even more difficult for patients and caregivers to distinguish between credible resources and false information. Various studies have focused on researching and documenting online cancer misinformation, finding that a significant portion of cancer-related content contains false information (Ben-Ari, 2021). The information presented can include inaccurate details about treatments, therapies, causes of cancer, and prevention strategies. Other studies have highlighted general health information spread on social media platforms (Suarez-Lledo V., Alvarez-Galvez J., 2021). A study in the Journal of the National Cancer Institute on harmful information found that various posts about breast, prostate, colorectal, and lung cancer, the four most common cancers, had misinformation (Johnson et al., 2022). Another study analyzed the misinformation found on Weibo, the Chinese equivalent of Twitter, regarding gynecologic-related misinformation spread on social media platforms (Chen et al., 2018). Some studies have even gathered a plethora of evidence regarding cancer misinformation seen on social media and tested whether or not it is scientifically accurate, finding that 19% 2 of cancer misinformation was not medically or scientifically accurate (Gage-Bouchard et al., 2018). Together, these studies signify the prevalence of misinformation on social media and online platforms. However, evidence regarding how social media platforms spread misleading, false information to patients and caregivers is sparse. The goal of our study was to describe patients with cancer and caregivers’ experiences using social media to gain cancer information, including their experiences with misleading cancer information on social media. The Cancer misInformation Research among Caregivers and patiEnts (CIRCLE) Study was conducted using surveys and interviews about which social media platforms were used the most and what specific misinformation each individual encountered. The results demonstrate the extent of cancer misinformation spread on various social media platforms. The findings highlight how much inaccurate knowledge and advice are escalated with the help of the media, emphasizing the amplification of misinformation through social media due to its accessibility and rampant use, being a first resort for many people to gather health information. METHODS Participant Recruitment The Cancer misInformation Research among Caregivers and patiEnts (CIRCLE) Study was conducted at the University of Arizona Cancer Center and the University of Utah. Data were collected from March 2021 to August 2021. Patients with cancer were eligible for this study if they were 1) ages 15-39 at the time of participation, 2) diagnosed with any form of cancer between the ages of 15-39, 3) using social media at least weekly, and 4) were able to speak and understand English. Cancer caregivers were eligible for this study if they were 1) caregiving to a patient who was diagnosed with cancer between the ages of 15-39, 2) aged 3 18 or older at the time of the patient’s diagnosis, 3) using social media at least weekly, and 4) capable of speaking and understanding English. Participants were primarily recruited online, due to the Covid-19 pandemic, through multiple avenues. We used ResearchMatch, an online tool connecting researchers to individuals who met the study’s inclusion criteria. Additionally, the study was advertised on social media platforms and through online cancer news outlets (e.g., Cancer Today Newspaper). In addition to online recruitment, multiple oncology clinics provided referrals to the study throughout Arizona and Utah. Clinical locations included The University of Arizona Cancer Center (Phoenix and Tucson locations), Diamond’s Children Hospital Pediatric Hematology/Oncology Division throughout multiple clinics in Arizona, including the Glendale satellite clinic, and the Huntsman-Intermountain Intermountain Adolescent and Young Adult Oncology Program (HIAYA) at the Huntsman Cancer Institute and Intermountain Healthcare in Salt Lake City, Utah. Staff recruited patients and caregivers throughout these clinics by approaching them with information regarding the study's aims and obtaining their contact information if they met the qualifications and wanted to participate. Data Collection All participants were screened by a team member to confirm eligibility and complete the informed consent process. Next, participants were invited to complete an online survey through REDCap. The online survey had 130 questions regarding their sociodemographics, social media use, cancer experiences, and their activity on social media platforms. Participants were then asked for permission to be recontacted for a follow-up interview at the end of the survey. Participants selected for the follow-up interview were purposively contacted to ensure representation based on age, sex, and caregiver/patient status. Participants 4 who agreed were interviewed about their personal experiences with cancer, social media, and viewing misinformation. Whether participants were exposed to misinformation was determined based on their response to being asked whether they had encountered any misleading or inaccurate cancer information online. All interviews were audio recorded, transcribed, and quality checked. Once the interview was completed, the research team confirmed the contact information of each participant and provided them with a $40 gift card for their participation. Transcriptions underwent quality checks to ensure accuracy and completeness. This approach not only ensured thorough data collection but also acknowledged and incentivized participant involvement in the research process. Misinformation Exposure Content Analysis Following the completion of interviews, one team member (JP) reviewed and coded all of the interviews for experiences with online cancer misinformation exposure (yes, no). Each transcript was thoroughly read to identify instances where participants reported encountering misinformation related to cancer or clearly indicated they had not experienced this. Coding difficulties and definitions of misinformation exposure were discussed with a second member of the research team (ELW) during bi-weekly meetings through consensus (Elo & Kyngäs, 2008). This content analysis aimed to distinguish instances where individuals perceived information as misleading or inaccurate, contributing valuable insights into the prevalence and nature of misinformation in online cancer sources. This methodical approach ensured that findings accurately reflected participants' experiences and provided a nuanced understanding of the impact of misinformation on social media platforms within the context of cancer information-seeking behaviors. 5 Survey Data Analysis Sociodemographics, cancer factors, and social media use characteristics were summarized using descriptive statistics. We conducted bivariate chi-square and Fisher Exact tests (for cells with n<5 responses) to examine differences in misinformation exposure, specifically whether participants reported viewing misinformation differentially, based on sociodemographic characteristics, cancer-related factors, and patterns of social media use. All analyses were performed in Stata 18.0. Statistical significance was determined at p<0.05. RESULTS Patient and Caregiver Characteristics ​ There were n=21 individuals affected by cancer, including both patients and caregivers, who completed a survey about their experiences with cancer-related misinformation on social media. The majority of individuals self-identified as female (66.7%, n=14). Most of the individuals who participated identified as Non-Hispanic White (95.2%, n=20) and most participants were patients (80.9%, n=17). Participants who disclosed their age at diagnosis were more frequently diagnosed >30 years old (57.1%, n=12). As identified in Table 1, most participants self-reported that they had viewed misinformation during the survey (57.1%, n=12). Table 1: Sociodemographics and Cancer Factors by Misinformation Exposure Age (in years) Self-Identified Gender Female Male Ethnicity1 Hispanic/Latino Viewed misinformation (n=12) Did not view misinformation (n=9) Mean (SD) Range Mean (SD) Range 33.25(2.5) N 29-37 % 31.13(6.2) N 17-36 % p-value 0.55 1 9 3 75.0 25.0 5 3 62.5 37.5 1 8.3 0 0.0 0.37 6 Non-Hispanic White Race AI/AN Asian Black White Other Multiple Cancer Factors Patient or Caregiver Patient Caregiver 11 91.7 9 100.0 1 1 4 5 1 0 8.3 8.3 33.3 41.7 8.3 0.0 0 0 2 6 0 1 0.0 0.0 22.2 66.7 0.0 8.3 11 1 91.7 8.3 6 3 66.7 33.3 0.49 0.15 Age at Diagnosis2 <30 years 3 25.0 3 33.3 >30 years 9 75.0 6 66.7 Diagnosis type Leukemias 0 0.0 2 22.2 Lymphomas 4 33.3 1 11.1 Carcinomas 7 58.3 4 44.4 CNS tumors 1 8.3 2 22.2 1 Missing n=1 2Missing n=9 CNS=Central Nervous System, Misinformation status missing for n=1. 0.52 0.32 Based on the data presented in Table 1, males and females reported similar prevalence of viewing or not viewing misinformation. Additionally, while a higher proportion of individuals diagnosed with carcinomas reported viewing cancer misinformation online, this difference did not reach statistical significance. Table 2: Social Media Platforms by Misinformation Exposure (N=21) Total using Viewed misinformation Social Media Platform N % N % Facebook 17 77.2 8 47.1 X (Twitter) 6 27.3 4 66.7 Instagram 15 68.1 8 53.3 Snapchat 3 13.6 2 66.7 TikTok 3 13.6 2 66.7 WhatsApp [phone] Pinterest 6 27.2 5 83.3 YouTube 9 40.9 5 55.6 Did not view misinformation N % 9 52.9 2 33.3 7 46.7 1 33.3 1 33.3 1 20.0 1 16.7 4 44.4 The most common social media platform used by the participants in this study was Facebook (77.2%, n=17), followed by Instagram (68.1%, n=15). While Facebook and Instagram were the most broadly used social media platforms, they had the lowest proportions of individuals reporting viewing misinformation with only 47.1% (n=8) of Facebook users and 53.3% (n=8) p-value 0.08 0.48 0.48 0.61 0.61 0.22 0.15 0.62 7 of Instagram users viewing misinformation. In comparison, 83.3% (n=5) of Pinterest users, and 80.0% (n=4) of WhatsApp users reported viewing misinformation. It is important to identify that misinformation was highly viewed on social media ranging from 47.1% of Facebook users to 83.3% of Pinterest users. This finding highlights the pervasive nature of misinformation across various platforms and underscores the need for interventions beyond the most commonly used sites, such as Facebook. Table 3: Identify different patterns and characteristics of inaccurate online cancer information by cancer factors (N=21). Misinformation Conspiracy theories Yes No N % N % 0 0.0 2 14.3 3 50.0 2 14.3 2 33.3 8 57.1 1 16.7 2 14.3 Treatment Yes No Yes No Diagnosis N % N % N % N % Leukemias 0 0.0 2 22.2 1 7.7 1 12.5 Lymphomas 4 33.3 1 11.1 3 23.1 2 25.0 Carcinomas 7 58.3 4 44.4 7 53.8 4 50.0 CNS tumors 1 8.3 2 22.2 2 15.4 1 12.5 Patient or caregiver Patient 7 87.5 5 62.5 4 80.0 8 72.7 8 72.7 4 80.0 Caregiver 1 12.5 3 37.5 1 20.0 3 27.7 3 27.3 1 20.0 Age at diagnosis <30 years 3 25.0 3 33.3 2 33.3 4 28.6 5 38.5 1 12.5 >30 years 9 75.0 6 66.7 4 66.7 10 71.4 8 61.5 7 87.5 *All comparisons were nonsignificant with p>0.05. Misinformation status missing for n=1. Diet/nutrition N 1 3 9 1 Yes % 7.1 21.4 64.3 7.1 N 1 2 2 2 No % 14.3 28.6 28.6 28.6 8 3 72.7 27.3 4 1 80.0 20.0 3 10 28.6 71.4 2 5 28.6 71.4 In Table 3, among those who had viewed misinformation, 58.3% (n=7) had carcinomas, 87.5% (n=7) were patients, and 75% (n=9) were over the age of 30. Among those who had viewed conspiracy theories, 50% (n=2) had lymphomas, 80% (n=4) were patients, and 66.7% (n=4) were over the age of 30 years old. Among patients who viewed inaccurate cancer treatment information, 53.8% (n=7) had carcinomas, 72.7% (n=8) were patients, and 61.5% (n=8) were over the age of 30. Finally, among those who viewed inaccurate diet/nutrition information related to cancer, 64.3% (n=9) had carcinomas, 72.7% (n=8) were patients, and 71.4% (n=10) were over 30 years old. Based on Table 3, 87.5% (n=7) of patients viewed misinformation, 80% (n=4) of patients viewed conspiracy theories, 72.7% (n=8) of patients had viewed treatment misinformation, and 72.7% (n=8) of patients 8 viewed diet or nutrition-related cancer misinformation. In comparison, 12.5% (n=1) of caregivers viewed misinformation, 20% (n=1) of caregivers viewed conspiracy theories, 27.3% viewed treatment misinformation, and 27.3% (n=3) of caregivers viewed diet or nutrition misinformation. Also, according to the data collected, it was more common for older participants to have viewed this information online. Table 3 identifies that >60% of individuals who viewed misinformation were above the age of 30 years. DISCUSSION We described the perceptions of individuals who believed that they had viewed cancer misinformation online. Understanding patterns of viewing cancer misinformation may inform future interventions that are designed to reduce the negative impact of viewing misleading and inaccurate cancer information on the internet, and the subsequent impact this information consumption may have on health beliefs and behaviors. We hereafter describe how our results reflect and contrast the existing literature about online health misinformation. The lack of regulation, lack of medical expert opinions in lay media, misunderstanding of online cancer information, and confirmation bias can all influence the presence of cancer misinformation online (Chou & Gaysynsky, 2020). The primary group of individuals who viewed misinformation in our study were females. This reflects the same prevalence of social media use trends among the platforms that our participants used which had the highest proportion of misinformation reporting. Based on another research article, 56% of women used Facebook, 56% of women used Instagram, 73% of women used Pinterest, and 57% of individuals used Snapchat, in comparison to men (Pew Research, 2024). In other words, women are the highest users of Pinterest, and the highest proportion of misinformation viewers in our study were users of Pinterest. Addressing misinformation may 9 require platform-specific strategies, especially considering that different groups tend to use different social media platforms more heavily. In addition, most participants in this study had a carcinoma diagnosis, which is more commonly seen in older adults, potentially increasing their exposure to cancer-related misinformation online. A carcinoma diagnosis is very common in the US each year (Cleveland Clinic, 2025), meaning that information about carcinomas may be more prevalent and popular online than other diagnoses. Although there were many social media platforms mentioned in these surveys, Facebook and Instagram were the most frequently used, making it very common for individuals to seek out information on them Clinicians should proactively discuss online misinformation with patients, particularly those with a new diagnosis, while researchers should prioritize studying misinformation trends specific to highly used platforms such as Facebook and Instagram. Diet Management and Advice One of the primary things that participants reported seeing on social media is diet-related information to help combat their cancer diagnosis. This can be seen as a positive for many, but other individuals report having a hard time figuring out what information is credible and truly accurate (Warner et al., 2022). Concerns ranged from uncertainty about the safety of certain supplements to anxiety over trying new foods without medical guidance (Warner et al., 2020). These individuals find themselves needing to ask their healthcare provider but reluctant to, which leaves them wondering what information is credible (Warner et al., 2020). Nutrition and dietary guidance are particularly vulnerable to misinformation because patients with cancer are often highly motivated to make lifestyle changes. Despite significant medical advances, cancer remains a challenging area of research because there is still a vast amount that remains unknown, particularly regarding how misinformation spreads, 10 how patients interpret online content, and what interventions are most effective in addressing false or misleading information. This cycle of confusion and misinformation leaves patients frustrated. Therefore, it is critical that patients feel supported in discussing dietary information with their healthcare providers, ensuring they are following nutrition advice that is both safe and beneficial to their treatment and recovery. Social Media Platforms The majority of social media platforms have been the root of misinformation for many individuals. Based on the information presented in this study, individuals have found themselves viewing aspects about their diagnosis that may be from the truth. While these statistics are very informative as to which social media platforms spread inaccurate information, it is important to identify exactly why these platforms do so. Social media platforms like Facebook and Instagram allow users to freely share content, which can lead to the spread of inaccurate or misleading information regarding cancer diagnoses. In addition, health information provokes an emotional response from individuals (Bujnowska-Fedak & Węgierek, 2020) which could cause people to share a post to gain a social connection or seek validation, not considering that there may be misinformation present. Facebook and Instagram had lower prevalence of misinformation compared to other social media platforms among our sample, however it is notable that even on the least common platforms, 47.1 and 53.3% of participants, respectively, viewed misinformation. As one can see by the data presented, there were still many individuals who reported that they did not see any misinformation at all, meaning that it may depend when and where people are finding information as well as their own health literacy and whether they accurately evaluate misinformation or not. This could be dictated by a specific search, keyword, or even who someone may be following on a social media platform. 11 Diagnosis We also collected information about the specific types of misinformation participants viewed and compared types of misinformation by individual-level factors (Table 3). For example, whether someone has a common kind of cancer or the rarest one in the world, they might have trouble finding different sources of information online. Seeking to fulfill unmet information is very common for patients with cancer(Springer et al., 2024) and may be a primary reason why people turn to the internet and social media for questions about cancer. The information presented in Table 3 identifies just what specific diagnoses led to those searching for further education. This is an interesting statistic based on the CIRCLE Study research because carcinoma is one of the most common types of cancer, accounting for 80-90% of all cases (Cleveland Clinic, 2024). This makes sense as to why so many individuals were able to find information on social media platforms regarding carcinomas as a whole. Limitations While this study provides insight into cancer misinformation spread on social media platforms, certain limitations must be identified to provide context for the findings. The sample size (n=21) may have been too small of a sample size to generalize findings in comparison to a larger population. In addition, data collection methods related to issues with the survey or interview could have introduced response bias, where these individuals may not have answered truthfully. The results could have been impacted by response bias, meaning that participants may have downplayed or exaggerated their encounters with cancer misinformation online. Recall bias may have also impacted the participants’ responses because they may not accurately remember the content they viewed on various platforms. 12 Missing data may have impacted the accuracy of the findings. While these limitations are present, the findings still provide valuable evidence on the topic of cancer misinformation spread in the media. Future studies with larger, more diverse sample sizes could identify if these findings hold true across varying populations. Despite these limitations, this study offers important preliminary insights into how cancer misinformation circulates on social media and how it is perceived by those affected by cancer. The findings underscore the urgent need for improved digital health literacy and greater clinical engagement around online content. Continued research with broader, more diverse samples and refined methods will be essential to better understand the impact of misinformation and to inform effective interventions that support patients and caregivers in navigating online health information accurately. CONCLUSION The Cancer misInformation Research among Caregivers and patiEnts (CIRCLE) Study sheds light on the issue of health misinformation on social media platforms, particularly in relation to cancer. The findings of the study show the alarming prevalence of misleading information that patients and caregivers encounter when seeking reliable information online. This study utilized surveys and interviews to explore participants' experiences, identifying the reliability of information shared on social media platforms. As social media continues to be a primary source of information for many individuals, efforts to halt the spread of misinformation are crucial. False information can influence health decisions, undermine trust in healthcare providers, and contribute to emotional burdens for those navigating a cancer diagnosis. By addressing challenges directly, individuals can be empowered to seek accurate information to enhance their knowledge to make informed health decisions on their own. 13 Facing these challenges can require various interventions, potentially including: promoting digital health literacy, encouraging evaluation of information found online, and holding platforms accountable for the accuracy of the information being shared. These interventions and methods can foster a more informed and strong information-seeking community. This approach both protects individuals from the harmful effects of social media misinformation, but may also help build a more resilient and knowledgeable community as a whole. Moving forward, continued research and collaboration between healthcare teams and social media platforms will be essential to create a safer and more reliable network for those seeking health information. 14 REFERENCES Ben-Ari, E.. (2021, September 9). The challenges of cancer misinformation on social media. The Challenges of Cancer Misinformation on Social Media - NCI. https://www.cancer.gov/news-events/cancer-currents-blog/2021/cancer-misinformatio n-social-media#:~:text=Indeed%2C%20a%20recent%20study%20found,%2C%20inac curate%2C%20or%20misleading%20information. Bujnowska-Fedak, M. M., & Węgierek, P. (2020, January 31). The impact of online health information on patient health behaviours and making decisions concerning health. International journal of environmental research and public health. https://pmc.ncbi.nlm.nih.gov/articles/PMC7037991/ Chen L, Wang X, Peng T Nature and Diffusion of Gynecologic Cancer–Related Misinformation on Social Media: Analysis of Tweets J Med Internet Res 2018;20(10):e11515 URL: https://www.jmir.org/2018/10/e11515 DOI: 10.2196/11515 Carcinoma: Types, treatment & what it is. Cleveland Clinic. (2024, September 27). https://my.clevelandclinic.org/health/diseases/23180-carcinoma Carcinoma: Types, treatment & what it is. Cleveland Clinic. (2025, March 19). https://my.clevelandclinic.org/health/diseases/23180-carcinoma Eleonora Teplinsky et al. Online Medical Misinformation in Cancer: Distinguishing Fact From Fiction. JCO Oncol Pract 18, 584-589(2022).DOI:10.1200/OP.21.00764 15 Elo, S., & Kyngäs, H. (2008). The qualitative content analysis process. Journal of advanced nursing, 62(1), 107–115. https://doi.org/10.1111/j.1365-2648.2007.04569.x Gage-Bouchard, E.A., LaValley, S., Warunek, M. et al. Is Cancer Information Exchanged on Social Media Scientifically Accurate?. J Canc Educ 33, 1328–1332 (2018). https://doi.org/10.1007/s13187-017-1254-z Liedke, J. (2022, October 27). U.S. adults under 30 now trust information from social media almost as much as from national news outlets. Pew Research Center. https://www.pewresearch.org/short-reads/2022/10/27/u-s-adults-under-30-now-trust-in formation-from-social-media-almost-as-much-as-from-national-news-outlets/ Marques, M. D., Douglas, K. M., & Jolley, D. (2022, May 2). Practical recommendations to communicate with patients about health-related conspiracy theories. The Medical journal of Australia. https://pmc.ncbi.nlm.nih.gov/articles/PMC9325074/ Pew Research Center. (2024, November 13). Social Media Fact sheet. Pew Research Center. https://www.pewresearch.org/internet/fact-sheet/social-media/ Skyler B Johnson, Matthew Parsons, Tanya Dorff, Meena S Moran, John H Ward, Stacey A Cohen, Wallace Akerley, Jessica Bauman, Joleen Hubbard, Daniel E Spratt, Carma L Bylund, Briony Swire-Thompson, Tracy Onega, Laura D Scherer, Jonathan Tward, Angela Fagerlin, Cancer Misinformation and Harmful Information on Facebook and Other Social Media: A Brief Report, JNCI: Journal of the National Cancer Institute, Volume 114, Issue 7, July 2022, Pages 1036–1039 Springer, F., Mehnert-Theuerkauf, A., Gebhardt, C., Stolzenburg, J.-U., & Briest, S. (2024, April 12). Unmet supportive care needs among cancer patients: Exploring cancer entity-specific needs and associated factors. Journal of cancer research and clinical 16 oncology. https://pmc.ncbi.nlm.nih.gov/articles/PMC11009727/#:~:text=Additionally%2C%20a %20substantial%20proportion%20of,unmet%20need%20across%20all%20domains. Suarez-Lledo V, Alvarez-Galvez J Prevalence of Health Misinformation on Social Media: Systematic Review J Med Internet Res 2021;23(1):e17187 URL: https://www.jmir.org/2021/1/e17187 DOI: 10.2196/17187 Sylvia Chou, W.-Y., & Gaysynsky, A. (2020). A prologue to the special issue: Health misinformation on social media. American Journal of Public Health, 110(S3). https://doi.org/10.2105/ajph.2020.305943 Warner, E. L., Basen-Engquist, K. M., Badger, T. A., Crane, T. E., & Raber-Ramsey, M. (2022). The Online Cancer Nutrition Misinformation: A framework of behavior change based on exposure to cancer nutrition misinformation. Cancer, 128(13), 2540–2548. https://doi.org/10.1002/cncr.34218 Warner, E. L., Waters, A. R., Cloyes, K. G., Ellington, L., & Kirchhoff, A. C. (2020). Young adult cancer caregivers’ exposure to cancer misinformation on social media. Cancer, 127(8), 1318–1324. https://doi.org/10.1002/cncr.33380 17 Name of Candidate:​ Jade Picco Date of Submission:​