Content Analysis of Bone Sarcoma-Related Hashtags on Instagram: Themes, Engagement Patterns, and Public Health Implications

Bone sarcomas are rare malignant neoplasms disproportionately affecting children and young adults. Despite the growing presence of disease-specific content on Instagram, the characteristics of bone sarcoma health communication on this platform remain uncharacterised. A cross-sectional content analysis of 1,201 publicly accessible Instagram posts collected over six months (July 2025–January 2026) using ten predefined bone sarcoma-related hashtags. Posts were coded into nine thematic categories by two independent raters. Engagement metrics were compared using Kruskal–Wallis tests. Patient narratives (28.4%) and motivational/inspirational content (22.8%) predominated. Patient/survivor accounts constituted 40.5% of posting accounts and exhibited the highest engagement rate (8.7%). Misinformation was identified in 5.7% of posts. Fundraising content generated the highest median shares (49); motivational posts yielded the highest median likes (318). Differences in engagement across categories were statistically significant (p < .001). Instagram hosts an active bone sarcoma community dominated by patient-generated content. Potentially harmful health claims were identified in a minority of posts, though their clinical impact cannot be determined from this study alone. These findings provide a descriptive foundation for future work examining the effects of social media health content on patient knowledge and behaviour in rare cancer populations.