title: Health-related quality of life and disease specific symptoms in long-term thyroid cancer survivors: a study from the population-based PROFILES registry.
abstract: BACKGROUND
  Given the longevity of thyroid cancer patients, any impairment in health-related quality of life (HRQoL) during the follow-up period is of considerable concern. Therefore, the first aim of this study was to assess (thyroid cancer specific) HRQoL among long-term thyroid cancer survivors and to compare this with the HRQoL of an age- and sex-matched normative population. Secondly, our aim was to investigate which clinical and socio-demographic characteristics and thyroid cancer specific problems were associated with HRQoL.
  
  
  METHODS
  All patients diagnosed with thyroid cancer between 1990 and 2008, as registered in the Eindhoven Cancer Registry, received a survey on HRQoL (EORTC QLQ-C30) and disease-specific symptoms (THYCA-QoL). The scores were compared with age- and sex-matched cancer free controls (n = 800). A series of multiple linear regression analyses were conducted to investigate the independent associations between clinical, socio-demographic and thyroid cancer specific factors with HRQoL.
  
  
  RESULTS
  A total of 306 patients (86%) responded to the invitation. Thyroid cancer survivors had significantly lower scores on physical, role, emotional, cognitive and social functioning (p < 0.001) compared to the normative population after adjusting for comorbidities. Sympathetic problems [feeling chilly (52%), hot flushes (40%)], neuromuscular problems [cramp legs (43%) and pain joints/muscles (64%)] and abrupt attacks of fatigue (50%) were the most often reported thyroid cancer specific complaints. Thyroid cancer specific neuromuscular, concentration, sympathetic and psychological problems explained 41-58% of the variance in HRQoL. Clinical and socio-demographic factors explained a small part of the variance in (thyroid cancer specific) HRQoL (1-27%).
  
  
  CONCLUSIONS
  Long-term thyroid cancer survivors experience more symptoms and deteriorated HRQoL compared to the normative population. Thyroid cancer specific neuromuscular, sympathetic, concentration and psychological symptoms are stronger associated with HRQoL than clinical and socio-demographic factors alone. Awareness of these specific determinants of HRQoL could help health care practitioners to provide better supportive care.
authors.affiliation: CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical Psychology and Neuropsychology, Tilburg University, The Netherlands. O.Husson@tilburguniversity.edu
authors.forename: Olga
authors.initials: O
authors.lastname: Husson
authors.forename: Harm R
authors.initials: HR
authors.lastname: Haak
authors.forename: Laurien M
authors.initials: LM
authors.lastname: Buffart
authors.forename: Willy-Anne
authors.initials: WA
authors.lastname: Nieuwlaat
authors.forename: Wilma A
authors.initials: WA
authors.lastname: Oranje
authors.forename: Floortje
authors.initials: F
authors.lastname: Mols
authors.forename: Johannes L
authors.initials: JL
authors.lastname: Kuijpens
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: Coebergh
authors.forename: Lonneke V
authors.initials: LV
authors.lastname: van de Poll-Franse
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012042:Registries / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology