Journal
THYROID
Volume 29, Issue 8, Pages 1080-1088Publisher
MARY ANN LIEBERT, INC
DOI: 10.1089/thy.2019.0163
Keywords
thyroid cancer; worry; survivors; recurrence; death
Categories
Funding
- National Cancer Institute (NCI) [R01 CA201198]
- AHRQ [R01 HS024512]
- National Institute on Aging [K08 AG049684]
- California Department of Public Health [103885]
- Centers for Disease Control and Prevention's (CDC) National Program of Cancer Registries [5NU58DP006344]
- NCI's SEER Program [HHSN261201800015I]
- NCI [HHSN261201800003I, HHSN26100001]
- CDC [5NU58DP003875-04]
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Background: Little is known about cancer-related worry in thyroid cancer survivors with favorable prognosis. Methods: A diverse cohort of patients diagnosed with differentiated thyroid cancer in 2014-2015 from the Surveillance, Epidemiology, and End Results (SEER) Program registries of Georgia and Los Angeles County were surveyed two to four years after diagnosis. Main outcomes were any versus no worry about harms from treatments, quality of life, family at risk for thyroid cancer, recurrence, and death. After excluding patients with recurrent, persistent, and distant disease, multivariable logistic regression was used to identify correlates of worry in 2215 disease-free survivors. Results: Overall, 41.0% reported worry about death, 43.5% worry about harms from treatments, 54.7% worry about impaired quality of life, 58.0% worry about family at risk, and 63.2% worry about recurrence. After controlling for disease severity, in multivariable analyses with separate models for each outcome, there was more worry in patients with lower education (e.g., worry about recurrence, high school diploma and below: odds ratio [OR] 1.78, 95% confidence interval [CI 1.36-2.33] compared with college degree and above). Older age and male sex were associated with less worry (e.g., worry about recurrence, age >= 65 years: OR 0.28 [CI 0.21-0.39] compared with age <= 44 years). Worry was associated with being Hispanic or Asian (e.g., worry about death, Hispanic: OR 1.41 [CI 1.09-1.83]; Asian: OR 1.57 [CI 1.13-2.17] compared with Whites). Conclusions: Physicians should be aware that worry is a major issue for thyroid cancer survivors with favorable prognosis. Efforts should be undertaken to alleviate worry, especially among vulnerable groups, including female patients, younger patients, those with lower education, and racial/ethnic minorities.
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