title: Health-related quality of life among thyroid cancer survivors: a systematic review.
abstract: BACKGROUND
  Treatment and follow-up care procedures of thyroid cancer impose great challenges on survivors and could potentially affect their health-related quality of life (HRQoL).
  
  
  METHODS
  Two authors systematically reviewed the available literature on HRQoL of thyroid cancer survivors. A PubMed literature search for original articles published until February 2011 was performed. Twenty-seven articles, published between 1997 and 2010, which met the predefined inclusion criteria, were subjected to a quality checklist.
  
  
  RESULTS
  All selected studies, except one, were of adequate or good quality. Surgery had a negative impact on short-term HRQoL scores, but these scores returned to preoperational levels when time since surgery increased. Long-term thyroid hormone therapy (levothyroxine) can lead to abnormalities like hyperthyroidism. HRQoL was most affected during thyroid hormone withdrawal for radioiodine remnant ablation or follow-up procedures. The use of recombinant human thyroid stimulating hormone instead of hormone withdrawal leads to considerable improvements in HRQoL during follow-up testing. The results for (long-term) survivors were contradicting. While most (long-term) survivors report some specific long-lasting health problems, some studies found a lower HRQoL for thyroid cancer survivors compared with a healthy population or other reference groups, whereas other studies found similar HRQoL levels.
  
  
  CONCLUSIONS
  This review indicates that thyroid cancer survivors generally have a similar or slightly worse HRQoL compared with the normative population; however, they report some specific medical problems after cancer treatment and follow-up tests, which have a direct negative impact on their current HRQoL and could affect their long-term HRQoL. Specific longitudinal survivorship studies are lacking.
authors: Department of Medical Psychology and Neuropsychology, CoRPS - Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands. o.husson@tilburguniversity.edu
authors: Olga
authors: O
authors: Husson
authors: Harm R
authors: HR
authors: Haak
authors: Wilma A
authors: WA
authors: Oranje
authors: Floortje
authors: F
authors: Mols
authors: Peter H M
authors: PH
authors: Reemst
authors: Lonneke V
authors: LV
authors: van de Poll-Franse