Social Media Discourse on Breast Cancer Screening Barriers in Japanese and English: Cross-Sectional Infodemiology Study.
Pain mentions for ultrasound spike when paired with mammography screening
Social Media Discourse on Breast Cancer Screening Barriers in Japanese and English: Cross-Sectional Infodemiology Study.
Despite clinical advances, breast cancer screening adherence remains stagnant in Japan (<50%) compared with the United States (>70%).
This study aims to characterize and compare cross-cultural informatics profiles of barriers to breast cancer screening across Japanese-language and English-language social media discourse.
We developed an automated natural language processing pipeline on a cloud-based informatics platform to analyze 46,823 screening-related posts (30,027 in Japanese and 16,796 in English) from X (formerly Twitter) collected in 2025, derived from an initial 76,955 posts after noise exclusion.
Pain-related posts about ultrasound rose from 5.0% to 18.2% when combined with mammography
Among the 46,823 screening-related posts, overall sentiment distributions showed no practically meaningful cross-cultural divergence (Cohen d=0.049); however, domain-specific analyses revealed sharp disparities in barrier prevalence.
Within the English-language cohort containing 16,796 posts, discourse exhibited a concentrated, moderate negative sentiment regarding systemic barriers, featuring "Cost" as the primary barrier (n=1239, 7.4%), while "Pain" ranked considerably lower (n=842, 5.0%).
Despite comparable overall emotional equilibrium, a fundamental dichotomy emerged.
The English-language discourse predominantly reflects US-specific systemic financial burdens, whereas the Japanese experience is characterized by emotional volatility transitioning from anticipatory anxiety to a tightly interconnected "Pain-Fear-Appointment" network.
Physical discomfort of mammography dominates the screening narrative, overshadowing concurrent painless modalities like ultrasound.