title: Decreased health-related quality of life in disease-free survivors of differentiated thyroid cancer in Korea.
abstract: BACKGROUND
  Concern regarding the health-related quality of life (HRQOL) of long-term survivors of thyroid cancer has risen due to the rapid increase in the incidence of thyroid cancer, which generally has an excellent prognosis. The aim of this study was to evaluate the status of HRQOL in disease-free survivors of differentiated thyroid carcinoma (DTC) and to evaluate the important determinants of HRQOL.
  
  
  METHODS
  This was a cross-sectional study in which we interviewed consecutive disease-free survivors of DTC. Three different validated questionnaires ("EORTC QLQ-C30" for various functional domains, the "brief fatigue inventory (BFI)" and the "hospital anxiety and depression scale" (HADS)) were used. Data from a large, population based survey of 1,000 people were used as a control.
  
  
  RESULTS
  The response rate for the questionnaires was 78.9% (316/401). Disease-free survivors of DTC showed a decreased HRQOL in all five functional domains (physical, role, cognitive, emotional, and social) on the EORTC QLQ-C30 compared with controls (P < 0.01). BFI and HADS-anxiety scores also showed greater distress in disease-free survivors of DTC than in controls (P < 0.05). A multiple regression analysis for the determinants of HRQOL showed that the HADS-anxiety, HADS-depression, and BFI scores were the most significant components of decreased HRQOL.
  
  
  CONCLUSIONS
  Although disease-free survivors of DTC are expected to have disease-specific survival comparable to the general population, they experience a significantly decreased HRQOL. Anxiety, depression, and fatigue were the major determinants of the decreased HRQOL. Supportive psychological care should be integrated into the management of long-term survivors of DTC.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Ji In
authors.initials: JI
authors.lastname: Lee
authors.forename: Soo Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Alice H
authors.initials: AH
authors.lastname: Tan
authors.forename: Hee Kyung
authors.initials: HK
authors.lastname: Kim
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Jang
authors.forename: Kyu Yeon
authors.initials: KY
authors.lastname: Hur
authors.forename: Jae Hyeon
authors.initials: JH
authors.lastname: Kim
authors.forename: Kwang-Won
authors.initials: KW
authors.lastname: Kim
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Chung
authors.forename: Sun Wook
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000503:physiopathology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D013964:Thyroid Neoplasms / Q000523:psychology* / Q000628:therapy