Published online Jan 20, 2023. doi: 10.5662/wjm.v13.i1.1
Peer-review started: October 6, 2022
First decision: November 22, 2022
Revised: November 29, 2022
Accepted: January 9, 2023
Article in press: January 9, 2023
Published online: January 20, 2023
Recent publications from several countries have reported that more young people (mainly girls) are experiencing precocious puberty (PP)/menarche during the coronavirus disease 2019 (COVID-19) pandemic compared to the past. This variation is attributed to the stress of confinement, lack of exercise, obesity and disturbed sleep patterns. Studies have shown that searches for diseases on the internet also reflect to some extent the epidemiology of these diseases.
A common feature of the relevant papers on the rise of PP, however, is the relatively small number of reported cases. With this study we aimed to estimate, through internet searches for PP, any changes in the epidemiology of PP.
We assessed in Google trends searches for 21 PP-related terms in English internationally, in the years 2017-2021. Additionally, we assessed local searches for selected terms, in English and local languages, in countries where a rise in PP has been reported.
Searches were collected in relative search volumes format and analyzed using Kendall’s Tau test, with a statistical significance threshold of P < 0.05.
Internationally, searches for three PP-related terms showed no noticeable change over the study period, while searches for eight terms showed a decrease. An increase was found over time in searches for nine PP-related terms. Of the 17 searches in English and local languages, in countries where a rise in PP has been reported, 5 showed a significant increase over time.
Over the study period, more than half of the search terms showed little change or declined. The discrepancy between internet searches for PP and the reported increase in the literature is striking. It would be expected that a true increase in the incidence of PP would also be aptly reflected in Google trends. If our findings are valid, then the literature may have been biased. The known secular trend of decreasing age of puberty may also have played a role.
The increase in the incidence of PP in the COVID-19 era, which is reported in the medical literature, is not fully reflected in internet searches. This is an evolving issue; hopefully further relevant studies will shed light on it.