Quality, reliability, and dissemination of lung cancer information on short-video platforms in China: a cross-platform content analysis of TikTok, Kwai, and Rednote

Background: Short-video platforms have become major sources of health information in China, influencing public awareness and health behavior. However, the quality and dissemination patterns of lung cancer-related content across different platforms remain unclear. This study aimed to evaluate the informational quality, reliability, and engagement patterns of lung cancer short videos on three leading Chinese platforms. Methods: We conducted a comprehensive cross-sectional content analysis of 1,288 lung cancer-related videos retrieved from TikTok, Kwai and Rednote. Video quality was systematically evaluated using a multidimensional toolkit, including the Journal of the American Medical Association (JAMA) benchmark criteria, Global Quality Scale (GQS), modified DISCERN (mDISCERN), and the Patient Education Materials Assessment Tool (PEMAT-U/A). We analyzed heterogeneity and correlations of quality and engagement metrics (likes, comments, shares, collections) across platforms, creator types, content themes, and presentation formats. Results: < 0.001). Disease knowledge videos-particularly those focusing on prevention, definitions, and risk factors-exhibited superior quality compared to personal experience or metastasis-related content. Expert monolog videos were the most common and effective presentation format. Engagement did not align linearly with quality. Patient vlogs and metastasis-related videos achieved higher interaction rates despite lower accuracy, indicating a "quality-engagement paradox." Weak-to-moderate positive correlations were found between GQS and engagement, while PEMAT-A was negatively correlated with likes and comments. Conclusion: Marked disparities in the quality and dissemination of lung cancer-related short videos exist across Chinese platforms. Professional, evidence-based content enhances reliability, whereas emotional and visually driven content drives engagement. Strengthening algorithmic governance, metadata transparency, and expert involvement-alongside audience-centered, evidence-informed communication-may enhance the educational value and public health impact of short-video platforms.