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Akriti Gupta Jain, Abdul Kareem Khan, Ranjeet Kumar, Mohammed Wazir, Syed Askari Hasan and Umair Majeed

Background: Breast Cancer (BC) is common, with 1 in 8 U.S. women (12.4%) developing invasive breast cancer in their lifetime. BC is associated with the most awareness campaigns with pink ribbon as its symbol. October was earmarked as the breast cancer awareness month (CAM) in 1985. Cervical (CC) and ovarian cancers (OC) are associated with a high mortality as well and have awareness months dedicated to them. The aim of these awareness drives is to change public attitude and help in early detection and ultimately prevention of various cancers. Internet search activity can be used as a method to gauge interest and awareness in the masses. We aimed to assess the popularity of BC compared to other gynecological cancers, including OC and CC. Methods: We compared the relative frequency of search terms “Breast Cancer,” “Ovarian Cancer,” and “Cervical Cancer” between January 1, 2004 and December 31, 2017 (n=168 months) using Google Trends, a public web facility of Google Inc. The software designates a reference value of 100 for the point of highest popularity and it provides relative monthly popularity scores for all the terms, which we termed as comparative interest scores (CIS). Within each cancer, average CIS was then compared for their respective awareness months (n=14 months; October for BC, September for OC, and January for CC) to the remaining months (n=154 months). Results: The mean CIS for BC was significantly higher during its CAM, 70.5 as compared to other months 35.9; p<0.001. However, for CC mean CIS during January (7.4) was not different compared to the other months (7.4); P=1.00. And for OC, CIS was significantly higher during its CAM (9.2) compared to other months (7.7); P=.0002. The peak of highest popularity for breast cancer was observed during October 2004 and all peaks corresponded to the CAM; other smaller peaks were seen during significant news events associated with BC, all of which surpassed OC and CC in those months. Overall BC CIS were significantly higher compared to CC (P<.001) and OC (P<.001). Conclusions: We conclude that BC awareness campaigns have succeeded in increasing internet search activity during its CAM but ovarian and cervical cancer campaigns especially when compared to breast cancer have not been as successful. There is still a need to increase awareness among masses. Google trends data also tells us which states in US have more internet search activity compared to others which can be used to target the relatively unaware public.