title: Using Google Trends Data to Study Public Interest in Breast Cancer Screening in Brazil: Why Not a Pink February?
abstract: BACKGROUND
  One of the major challenges of the Brazilian Ministry of Health is to foster interest in breast cancer screening (BCS), especially among women at high risk. Strategies have been developed to promote the early identification of breast cancer mainly by Pink October campaigns. The massive number of queries conducted through Google creates traffic data that can be analyzed to show unrevealed interest cycles and their seasonalities.
  
  
  OBJECTIVE
  Using Google Trends, we studied cycles of public interest in queries toward mammography and breast cancer along the last 5 years. We hypothesize that these data may be correlated with collective interest cycles leveraged by national BCS campaigns such as Pink October.
  
  
  METHODS
  Google Trends was employed to normalize traffic data on a scale from 0 (<1% of the peak volume) to 100 (peak of traffic) presented as weekly relative search volume (RSV) concerning mammography and breast cancer as search terms. A time series covered the last 261 weeks (November 2011 to October 2016), and RSV of both terms were compared with their respective annual means. Polynomial trendlines (second order) were employed to estimate overall trends.
  
  
  RESULTS
  We found an upward trend for both terms over the 5 years, with almost parallel trendlines. Remarkable peaks were found along Pink October months- mammography and breast cancer searches were leveraged up reaching, respectively, 119.1% (2016) and 196.8% (2015) above annual means. Short downward RSVs along December-January months were also noteworthy along all the studied period. These trends traced an N-shaped pattern with higher peaks in Pink October months and sharp falls along subsequent December and January.
  
  
  CONCLUSIONS
  Considering these findings, it would be reasonable to bring Pink October to the beginning of each year, thereby extending the beneficial effect of the campaigns. It would be more appropriate to start screening campaigns at the beginning of the year, when new resolutions are taken and new projects are added to everyday routines. Our work raises attention to the study of traffic data to encourage health campaign analysts to undertake better analysis based on marketing practices.
authors.affiliation: Laboratory of Innovation in Therapies, Teaching and Bioproducts /LITEBOswaldo Cruz Institute/IOCOswaldo Cruz FoundationRio de JaneiroBrazil.|Research CoordinationNational Cancer InstituteRio de JaneiroBrazil.
authors.forename: Paulo Roberto
authors.identifier: 0000-0003-4646-3580
authors.initials: PR
authors.lastname: Vasconcellos-Silva
authors.affiliation: Department of Computer ScienceFederal University of São João del-ReiSão João del-ReiBrazil.
authors.forename: Dárlinton Barbosa Feres
authors.identifier: 0000-0003-3844-0178
authors.initials: DBF
authors.lastname: Carvalho
authors.affiliation: Laboratory of Innovation in Therapies, Teaching and Bioproducts /LITEBOswaldo Cruz Institute/IOCOswaldo Cruz FoundationRio de JaneiroBrazil.
authors.forename: Valéria
authors.identifier: 0000-0002-7972-7899
authors.initials: V
authors.lastname: Trajano
authors.affiliation: Laboratory of Innovation in Therapies, Teaching and Bioproducts /LITEBOswaldo Cruz Institute/IOCOswaldo Cruz FoundationRio de JaneiroBrazil.|Institute of Letters. Sector of English LiteratureDepartment of Germanic LanguagesState University of Rio de Janeiro/UERJRio de JaneiroBrazil.
authors.forename: Lucia Rodriguez
authors.identifier: 0000-0002-0113-3484
authors.initials: LR
authors.lastname: de La Rocque
authors.affiliation: Laboratory of Innovation in Therapies, Teaching and Bioproducts /LITEBOswaldo Cruz Institute/IOCOswaldo Cruz FoundationRio de JaneiroBrazil.
authors.forename: Anunciata Cristina Marins Braz
authors.identifier: 0000-0002-1822-6679
authors.initials: ACMB
authors.lastname: Sawada
authors.affiliation: National School of Public HealthOswaldo Cruz FoundationRio de JaneiroBrazil.
authors.forename: Leidjaira Lopes
authors.identifier: 0000-0001-8012-6006
authors.initials: LL
authors.lastname: Juvanhol
keywords: Internet; breast cancer; cancer information seeking; early detection of cancer; health communication; infodemiology; infoveillance; mass screening