Sang-Cheol Lee

Background: Internet search engines serve as primary gateways to cancer information; yet, the commercialization of health content within organic search results remains understudied. While covert promotional content—such as native advertising and stealth marketing—has been documented in various contexts, systematic comparisons across structurally divergent search platforms are lacking. Objective: This study examined the prevalence, distribution, and information quality characteristics of covert promotional cancer-related content across Naver and Google, South Korea’s 2 dominant search engines, which have fundamentally different platform architectures. Methods: A 2-phase cross-sectional content analysis was conducted. Phase 1 used natural language processing to identify 34 cancer-related keywords from 1400 preliminary posts. Phase 2 systematically collected 5848 posts in October 2023, yielding 919 unique posts (598 from Naver and 321 from Google) that covered 7 major cancer types, collectively accounting for over 70% of Korean cancer incidence. Two trained coders analyzed promotional status, intensity, institutional sources, and information quality indicators (citation practices, information depth, and source attribution), with intercoder reliability exceeding κ=0.80. Chi-square tests were used to examine associations between platform and content characteristics across cancer type. Results: Covert promotional content appeared in 48.6% (447/919) of analyzed posts, with a significantly higher prevalence on Google (174/321, 54.2%) than on Naver (273/598, 45.7%; χ ² ₁ =5.78; P =.02). Platform differences were pronounced. Naver promotional posts predominantly originated from blogs (262/273, 96.0%) and exhibited full promotional intensity (126/242, 52.1%), while Google posts primarily came from hospital websites (141/174, 81.0%) with simple institutional identification (52/90, 57.8%). Institutional source distribution varied significantly by platform ( χ ² ₅ =209.642; P< .001). Traditional medicine institutions dominated Naver (119/120, 99.2%), whereas university-affiliated hospitals predominated on Google (96/113, 85.0%). Information quality also differed substantially. Indirect citation was more common on Google (142/174, 81.6%) than on Naver (160/273, 58.6%; χ ² ₁ =25.653; P<. 001), while comparative informational depth was higher on Google (97/174, 55.7%) versus Naver (53/273, 19.4%; χ ² ₂ =64.683; P<. 001). Conclusions: Covert promotional cancer content is pervasive in Korean search results, with platform architecture systematically shaping promotional patterns, institutional sources, and information quality rather than reflecting deliberate marketing strategies. These findings underscore the need for platform-sensitive regulation and enhanced digital health literacy to protect vulnerable cancer information seekers from commercial exploitation embedded within ostensibly neutral search environments.

BACKGROUND Internet search engines serve as primary gateways for cancer information, yet the commercialization of health content within organic search results remains understudied. While covert promotional content—such as native advertising and stealth marketing—has been documented in various contexts, systematic comparisons across structurally divergent search platforms are lacking. OBJECTIVE This study examined the prevalence, distribution, and information quality characteristics of covert promotional cancer-related content across Naver and Google, South Korea's two dominant search engines, which have fundamentally different platform architectures. METHODS A two-phase cross-sectional content analysis was conducted. Phase 1 employed natural language processing to identify 33 cancer-related keywords from 1,400 preliminary posts. Phase 2 systematically collected 5,848 posts in October 2023, yielding 919 unique posts (598 from Naver and 321 from Google) that covered seven major cancer types, representing over 70% of Korean cancer incidence. Two trained coders analyzed promotional status, intensity, institutional sources, and information quality indicators (citation practices, information depth, and source attribution), with inter-coder reliability exceeding κ=.80. Chi-square tests examined the associations between platform and cancer type. RESULTS Covert promotional content appeared in 48.6% (447/919) of analyzed posts, with significantly higher prevalence on Google (54.2%, 174/321) than Naver (45.7%, 273/598; χ²₁=5.78, p=.016). Platform differences were pronounced: Naver promotional posts predominantly originated from blogs (96.0%, 262/273) and exhibited full promotional intensity (52.1%, 126/242), while Google posts primarily came from hospital websites (81.0%, 141/174) with simple institutional identification (57.8%, 52/90). Institutional source distribution varied significantly by platform (χ²₅=215.714, P<.001): traditional medicine institutions dominated Naver (99.2%, 119/120), whereas university-affiliated hospitals predominated on Google (85.0%, 96/113). Information quality differed substantially: indirect citation was more common on Google (81.6%, 142/174) than Naver (58.6%, 160/273; χ²₁=25.653, P<.001), while comparative informational depth was higher on Google (55.7%, 97/174) versus Naver (19.4%, 53/273; χ²₂=64.683, P<.001). CONCLUSIONS Covert promotional cancer content is pervasive in Korean search results, with platform architecture systematically shaping promotional patterns, institutional sources, and information quality rather than reflecting deliberate marketing strategies. These findings underscore the need for platform-sensitive regulation and enhanced digital health literacy to protect vulnerable cancer information seekers from commercial exploitation embedded within ostensibly neutral search environments.

Barriers to Clinical Trial Enrollment: KCSG Survey-Based Perspectives of Medical Oncologists, Patients, and Their Caregivers

PURPOSE: A precise oncologic approach for head and neck squamous cell carcinoma (HNSCC) is necessary. We performed a genomic profile-based umbrella trial for the patients with platinum-refractory recurrent and/or metastatic HNSCC. METHODS: In this multicenter, open-label, single-arm phase II trial, we performed targeted next-generation sequencing (NGS). Patients were assigned to each treatment arm on the basis of their matching genomic profiles: arm 1, alpelisib, a PIK3CA inhibitor; arm 2, poziotinib, an epidermal growth factor receptor/HER2 inhibitor; arm 3, nintedanib, an fibroblast growth factor receptor inhibitor; and arm 4, abemaciclib, a CDK4/6 inhibitor. If there was no matching target, patients were allocated to arm 5, duvalumab ± tremelimumab, anti–PD-L1/cytotoxic T-cell lymphocyte-4 inhibitor. When progressive disease (PD) occurred in arms 1-4, cross over to arm 5 was allowed. The primary end point was disease control rate (DCR) in arm 1 and overall response rate (ORR) in arms 2-5 by investigator assessment. RESULTS: Between October 2017 and August 2020, 203 patients were enrolled, including crossover. In arm 1, the ORR was 21.2% and DCR was 65.6%. The ORR was 0% for arm 2, 42.9% for arm 3, 0% for arm 4, and 15.6% for arm 5. In the case of PD with durvalumab, tremelimumab was added, and the ORR for durvalumab + tremelimumab was 2.2%. The median progression-free survival was 3.4, 3.2, 5.6, 1.6, and 1.7 months for each arm, respectively. The median overall survival was 12.4, 6.1, 11.1, 9.1, and 12.7 months, respectively. Overall, the toxicity profiles were manageable, and there were no treatment-related deaths. CONCLUSION: To our knowledge, this study is the first biomarker-driven umbrella trial for platinum-refractory HNSCC using matched molecular targeted agents. We found that NGS-based genomic phenotyping was methodologically feasible and applicable.

Oral mucositis (OM) is a debilitating adverse event in patients undergoing treatment for cancer. This study aimed to evaluate the therapeutic effect of a novel handheld photobiomodulation therapy (PBMT) device on chemoradiation therapy (CRT)-induced OM in patients with head and neck cancer. Head and neck cancer patients undergoing CRT who developed moderate-to-severe OM during treatment were enrolled. After PBMT and at 2 and 4 weeks after PBMT, the mean value of OM grade decreased significantly from 2.63 to 2.13, 1.31, and 0.75, respectively (p < 0.05, p < 0.001, and p < 0.001). Moreover, we observed significant improvement in health-related quality of life (HRQoL) after PBMT compared to baseline through a validated questionnaire; EORTC QLQ-C30. In the present study, the use of this PBMT device in the management of CRT-induced OM in patients with head and neck cancer was generally well tolerated and resulted in the improvement of OM. However, evidence supporting its use remains lacking owing to limitations such as the small number of participants and lack of a control group. Therefore, further mechanistic studies and large-scale randomized controlled trials are needed to confirm the effectiveness of PBMT in the treatment of CRT-induced OM, as shown in our results.

[This corrects the article DOI: 10.2196/39571.].

Background: A knowledge gap exists between the list of required actions and the action plan for countering cancer misinformation on social media. Little attention has been paid to a social media strategy for disseminating factual information while also disrupting misinformation on social media networks. Objective: The aim of this study was to, first, identify the spread structure of cancer misinformation on YouTube. We asked the question, “How do YouTube videos play an important role in spreading information about the self-administration of anthelmintics for dogs as a cancer medicine for humans?” Second, the study aimed to suggest an action strategy for disrupting misinformation diffusion on YouTube by exploiting the network logic of YouTube information flow and the recommendation system. We asked the question, “What would be a feasible and effective strategy to block cancer misinformation diffusion on YouTube?” Methods: The study used the YouTube case of the self-administration of anthelmintics for dogs as an alternative cancer medicine in South Korea. We gathered Korean YouTube videos about the self-administration of fenbendazole. Using the YouTube application programming interface for the query “fenbendazole,” 702 videos from 227 channels were compiled. Then, videos with at least 50,000 views, uploaded between September 2019 and September 2020, were selected from the collection, resulting in 90 videos. Finally, 10 recommended videos for each of the 90 videos were compiled, totaling 573 videos. Social network visualization for the recommended videos was used to identify three intervention strategies for disrupting the YouTube misinformation network. Results: The study found evidence of complex contagion by human and machine recommendation systems. By exposing stakeholders to multiple information sources on fenbendazole self-administration and by linking them through a recommendation algorithm, YouTube has become the perfect infrastructure for reinforcing the belief that fenbendazole can cure cancer, despite government warnings about the risks and dangers of self-administration. Conclusions: Health authorities should upload pertinent information through multiple channels and should exploit the existing YouTube recommendation algorithm to disrupt the misinformation network. Considering the viewing habits of patients and caregivers, the direct use of YouTube hospital channels is more effective than the indirect use of YouTube news media channels or government channels that report public announcements and statements. Reinforcing through multiple channels is the key.

Various hematologic side effects of the Coronavirus Disease 2019 (COVID-19) vaccination has been reported, and most of them are thought to be related to autoimmune pathways. To the best of our know...

BACKGROUND A knowledge gap exists between the list of required actions and the action plan for countering cancer misinformation on social media. A social media strategy to deliver factual information while also disrupting disinformation on a social media network has garnered little attention OBJECTIVE This study is intended, first, to identify the spread structure of cancer misinformation on YouTube. How do YouTube videos play an important role to spread the self-administration of Anthelmintic for dogs as cancer medicine? Second, the study is intended to suggest the action strategy for stopping misinformation on YouTube by exploiting the logic of YouTube information flow and recommender system. What would be the effective strategy to stop cancer misinformation on YouTube? METHODS The study used the YouTube case on the Self-Administration of Anthelmintic for dogs as alternative cancer medicine in South Korea. We gathered the Korean YouTube videos on the self-administration of Fenbendazole. It was retrieved using YouTube API for the query "Fenbendazole" and 702 videos from 227 channels were compiled. Then, at least 50,000 views and uploaded between September 2019 and September 2020 were chosen from the collection. Finally, the 10 suggested videos for each video were compiled, totaling 573 videos. Social network visualization for 573 recommended videos is used to identify three intervention strategies for disrupting the The study found the evidence of so-called ‘complex contagion’ by human and recommender system. By exposing stakeholders to multiple information sources on Fenbendazole self-administration personal reviews and linking them via recommender algorithm, YouTube has become the perfect infrastructure for reinforcing the belief that Fenbendazole can cure cancer, despite government warnings of self-administration risks and dangers.YouTube misinformation network. RESULTS The study found the evidence of so-called ‘complex contagion’ by human and recommender system. By exposing stakeholders to multiple information sources on Fenbendazole self-administration personal reviews and linking them via recommender algorithm, YouTube has become the perfect infrastructure for reinforcing the belief that Fenbendazole can cure cancer, despite government warnings of self-administration risks and dangers. CONCLUSIONS Health authority should upload pertinent information through ‘multiple’ channels and should exploit existing YouTube recommendation algorithm to disrupt misinformation network. Considering the viewing habits of patients and caregivers, the direct use of hospital channels is more effective than the indirect use of news media channels through public announcement and statement or government channels. Reinforcing through multiple channels is the key.