BACKGROUND Social media platforms, particularly short-form videos on Instagram (known as “Reels”), have become widely used sources of health information for the general public and cancer patients. However, a widening gap exists between evidence-based clinical guidance and popular wellness narratives, often impacting patient health literacy and treatment decisions. OBJECTIVE This study aimed to quantitatively compare the readability and emotional sentiment of cancer-related content produced by institutional/medical accounts, wellness influencers, and patients on Instagram Reels. METHODS Using a newly created Instagram account to avoid preformed content algorithms affecting search results, a cross-sectional content analysis was conducted on 50 publicly available Reels (25 from board-certified clinicians/academic institutions and 25 from holistic/wellness influencers and patients). Visual text was manually transcribed, and audio was transcribed using the Microsoft Word Dictate tool, with accuracy being confirmed by the authors. Linguistic complexity was assessed via the Flesch-Kincaid Grade Level formula and Flesch Reading Ease Score, and emotional sentiment was quantified using the VADER (Valence Aware Dictionary and sEntiment Reasoner) sentiment lexicon to calculate a normalized compound score (-1.0 to +1.0). Differences between account types were evaluated using Fisher’s exact, pooled, and Satterthwaite tests, while engagement metrics (views, likes, and likes per 1,000 views) were compared using Wilcoxon rank-sum tests. All analyses were performed using SAS 9.4 with a two-sided significance threshold of p < 0.05. RESULTS Medical/Institutional Reels demonstrated a higher average reading complexity (Mean Grade Level = 8.91 ± 4.03 vs. 6.45 ± 2.47 for wellness accounts; p = 0.013), indicating approximately 9th-grade versus 6th-grade complexity. Mean VADER compound sentiment scores did not differ significantly between account types (Mean 0.10 ± 0.40 vs. 0.14 ± 0.57, p = 0.77). Wellness/Influencer accounts commanded substantially higher median like counts (5,483 vs. 360 likes; p = 0.010); however, engagement efficiency was equivalent between groups, yielding similar median like rates (21.3 vs. 20.1 likes per 1,000 views; p = 0.48). CONCLUSIONS Well-meaning academic institutions and oncology clinicians lock evidence-based data behind dense clinical jargon that often exceeds the average reading level of half the U.S. population. Conversely, wellness and influencer accounts utilize highly accessible, easy-to-read plain language. This can result in the dissemination of medical misinformation that can range from moderately incorrect to dangerous. To effectively increase the spread of evidence-based cancer information and audience engagement, medical professionals should adapt short-form video strategies to prioritize easy-to-understand language, use reading-level calculators, and adopt user-trust techniques such as validation badging.

Wildland firefighters play a critical role in protecting communities and natural resources, yet comparatively little research has examined the occupational health risks associated with repeated smoke exposure. This narrative review analyzed documented health effects, contributing exposure determinants, and mitigation strategies across 38 studies meeting pre-specified inclusion criteria. Included studies were predominantly quantitative field investigations evaluating pulmonary, cardiovascular, metabolic, and chemical exposure outcomes. Consistent findings documented decreased lung function, elevated oxidative stress, increased carbon monoxide (CO) exposure, and cumulative cardiovascular risk. Wildland firefighters were associated with polycyclic aromatic hydrocarbon (PAH) levels 2.2–26.7 times higher than controls. Prescribed burns produced CO concentrations 233% higher than off-fire-line days. Cardiovascular disease accounts for approximately 45% of annual line-of-duty fatalities among U.S. firefighters. Contributing factors included career duration, fire type, and operational role. Altogether, these findings underscore the severe, multi-system health risks faced by wildland firefighters and highlight a pressing need for modern mitigation strategies and firefighter-specific protective technologies to safeguard long-term health.