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Background The use of social media as a source of health information is increasing, and the usefulness of the content may vary depending on the specific disease. Thus, this study was designed to assess the content, viewer engagement and usefulness of the most viewed YouTube videos on lung cancer. Methods 167 videos were reviewed, and 143 met the eligibility criteria. Two authors evaluated the videos separately, and data on views, likes, dislikes and comments were extracted, and data on the source of uploader, duration and content quality were recorded. Results 89 videos (62%) were classified as useful, 8 (6%) as misleading and 46 (32%) as neither. The misleading videos were significantly more popular in terms of views and likes compared with the useful videos: 845 643 versus 81 700, P = 0.003 and 12 170 versus 415, P < 0.001, respectively. Conclusions This study shows that YouTube videos on lung cancer are popular and that around two-thirds of the videos are useful in terms of patient education. However, the misleading videos are currently attracting higher viewer interaction and might compose a future challenge in terms of the spread of misinformation as the algorithms will prioritize popular videos rather than videos with evidence-based information.

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