Twitter response to the United States Preventive Services Task Force recommendations against screening with prostate-specific antigen

BJU Int. 2015 Jul;116(1):65-71. doi: 10.1111/bju.12748. Epub 2015 Mar 25.


Objective: To examine public and media response to the draft (October 2011) and finalised (May 2012) recommendations of the United States Preventive Services Task Force (USPSTF) against prostate-specific antigen (PSA) testing via Twitter, a popular social network with over 200 million active users.

Materials and methods: We used a mixed-methods design to analyse posts on Twitter, known as 'tweets'. Using the search term 'prostate cancer', we archived tweets in the 24-h periods following the release of both the draft and the finalised USPSTF recommendations. We recorded tweet rate per h and developed a coding system to assess the type of user and sentiment expressed in tweets and linked articles.

Results: After the draft and finalised USPSTF recommendations were released, 2042 and 5357 tweets focused on the USPSTF report, respectively. The tweet rate nearly doubled within 2 h of both announcements. Fewer than 10% of tweets expressed an opinion about screening, and the majority of these were pro-screening during both periods. By contrast, anti-screening articles were tweeted more frequently in both the draft and finalised study periods. Between the draft and the finalised recommendations, the proportion of anti-screening tweets and anti-screening article links increased (P = 0.03 and P < 0.01, respectively).

Conclusions: There was increased Twitter activity surrounding the USPSTF draft and finalised recommendations. The percentage of anti-screening tweets and articles appeared to increase, perhaps due to the interval public comment period. Despite this, most tweets did not express an opinion, suggesting a missed opportunity in this important arena for advocacy.

Keywords: PSA; prostate cancer; screening; social media; task force.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Practice Guidelines as Topic*
  • Prostate-Specific Antigen / analysis*
  • Prostatic Neoplasms / diagnosis*
  • Social Media / statistics & numerical data*
  • United States


  • Prostate-Specific Antigen