Decreased health-related quality of life in disease-free survivors of differentiated thyroid cancer in Korea.
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.
Lee
Ji In
JI
Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kim
Soo Hyun
SH
Tan
Alice H
AH
Kim
Hee Kyung
HK
Jang
Hye Won
HW
Hur
Kyu Yeon
KY
Kim
Jae Hyeon
JH
Kim
Kwang-Won
KW
Chung
Jae Hoon
JH
Kim
Sun Wook
SW
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