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BACKGROUND: Esophageal cancer typically lacks specific early symptoms, leading to late-stage diagnosis and poor prognosis, with an overall low 5-year survival rate. However, early detection and timely intervention can significantly improve the 5-year survival rate, underscoring the importance of prevention, screening, and early intervention. Short video platforms are increasingly utilized for health communication, offering opportunities to disseminate medical knowledge. However, the quality and reliability of health-related content, particularly for diseases like esophageal cancer, remain under explored. OBJECTIVE: This study aimed to systematically evaluate the quality, reliability, completeness, and engagement of esophageal cancer-related videos on three popular short video platform: Bilibili, TikTok, and Kwai, to identify platform-specific strengths and limitations in disseminating health information. METHODS: A total of 311 esophageal cancer-related videos were analyzed. Video assessment was assessed using 4 standardized scoring framework including General Quality Scores (GQS) for general quality, the DISCERN for reliability, Completeness Score (CS) for comprehensive information, Engagement Score (ES) for understandability and entertainment value of the video. Video features (source, category, content), user's behavior (likes, shares, comments) were also collected. Cross-platform comparisons were conducted to identify disparities in content quality and user interaction. RESULTS: This study analyzed 311 esophageal cancer-related videos on Bilibili, TikTok, and Kwai. Video quality varied significantly across platforms, with Bilibili showing the highest DISCERN (5.46), GQS (2.97) and CS (3.64), while TikTok videos achieved the highest ES (2.88) and engagement metrics (e.g., likes and collections, p < 0.001). Kwai videos had the lowest scores across all measures. Content focused primarily on "symptoms" and "treatment," with Bilibili offering more comprehensive coverage. Correlation analysis revealed a positive association between video quality and engagement on Bilibili but a negative association on TikTok (e.g., GQS and likes, r=-0.251, P = 0.009). CONCLUSIONS: The quality of esophageal cancer-related videos across Bilibili, TikTok, and Kwai is suboptimal, with notable quality disparities among the platforms. Users on platforms other than Bilibili show limited ability to identify or prefer higher-quality content. This study underscores the potential of short-video platforms for esophageal cancer public health education, but highlights the need for improvements in content quality, ethical standards, and platform governance to address health equity concerns.
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