Risk Factors for Decreased Quality of Life in Thyroid Cancer Survivors: Initial Findings from the North American Thyroid Cancer Survivorship Study

Abstract

Background: The prevalence of thyroid cancer survivors is rising rapidly due to the combination of an increasing incidence, high survival rates, and a young age at diagnosis. The physical and psychosocial morbidity of thyroid cancer has not been adequately described, and this study therefore sought to improve the understanding of the impact of thyroid cancer on quality of life (QoL) by conducting a large-scale survivorship study. Methods: Thyroid cancer survivors were recruited from a multicenter collaborative network of clinics, national survivorship groups, and social media. Study participants completed a validated QoL assessment tool that measures four morbidity domains: physical, psychological, social, and spiritual effects. Data were also collected on participant demographics, medical comorbidities, tumor characteristics, and treatment modalities. Results: A total of 1174 participants with thyroid cancer were recruited. Of these, 89.9% were female, with an average age of 48 years, and a mean time from diagnosis of five years. The mean overall QoL was 5.56/10, with 0 being the worst. Scores for each of the sub-domains were 5.83 for physical, 5.03 for psychological, 6.48 for social, and 5.16 for spiritual well-being. QoL scores begin to improve five years after diagnosis. Female sex, young age at diagnosis, and lower educational attainment were highly predictive of decreased QoL. Conclusion: Thyroid cancer diagnosis and treatment can result in a decreased QoL. The present findings indicate that better tools to measure and improve thyroid cancer survivor QoL are needed. The authors plan to follow-up on these findings in the near future, as enrollment and data collection are ongoing.

Quality of Life and Cost-Effectiveness of Radiofrequency Ablation versus Open Surgery for Benign Thyroid Nodules: a retrospective cohort study

“…The propensity score presents the conditional probability of receiving an exposure given a vector of the measured covariates21. In our study, propensity scores for all the patients were estimated by multiple logistic-regression models using the following baseline characteristics as covariates: sex, age, nodule volume, ethnic group, SF-36 dimension scores (PF, RP, BP, GH, VT, SF, RE, MH), smoke, drink, chronic diseases, marital status, monthly income, education lever and current job22. Before matching, the mean propensity score was 0.425 for patients in the RFA group (n = 137) and 0.295 for patients in the OT group (n = 267), with a standardized difference of 80.7% (t-test, P  < 0.001).…”

Measurement and Variation in Estimation of Quality of Life Effects of Patients Undergoing Treatment for Papillary Thyroid Carcinoma

“…In the most recent cross-sectional survey of over 1000 thyroid cancer survivors, Grogan and colleagues reported a lower average overall score (5.6/10) compared with more aggressive cancers using a thyroidspecific neuropsychometric survey (City of Hope-QoL) (19). Additionally, patients reported a much higher prevalence of surgical complications and treatment related side effects than standard references.…”

“…Quality of life research has primarily focused on the physical side effects, and prospective, longitudinal data during the course of treatment are lacking (14)(15)(16). Neuropsychometric surveys have reported a decrement to quality of life for up to five years following treatment, on par with other cancers carrying worse prognoses (17)(18)(19). Qualitative analysis reveals emotional and financial impact on thyroid cancer on survivors of all stages of disease (20).…”

Explanatory Meetings on Thyroid Examination for the “Fukushima Health Management Survey” after the Great East Japan Earthquake: Reduction of Anxiety and Improvement of Comprehension

“…After the 1986 accident, some people who underwent thyroid screening also experienced complex socioeconomic problems, including evacuation, and reported psychological issues including higher rates of depression, suicide ideation, and attempted suicide (Contis and Foley 2015). Generally, quality of life after thyroid cancer surgery, especially for young people, is lower than that after other cancer surgeries, despite its good prognosis, because of the multiple effects including psychological ones (Aschebrook-Kilfoy et al 2015). These findings highlight the importance of risk communication and psychological care.…”