title: Risk Factors for Decreased Quality of Life in Thyroid Cancer Survivors: Initial Findings from the North American Thyroid Cancer Survivorship Study.
abstract: BACKGROUND
  The prevalence of thyroid cancer survivors is rising rapidly due to the combination of an increasing incidence, high survival rates, and a young age at diagnosis. The physical and psychosocial morbidity of thyroid cancer has not been adequately described, and this study therefore sought to improve the understanding of the impact of thyroid cancer on quality of life (QoL) by conducting a large-scale survivorship study.
  
  
  METHODS
  Thyroid cancer survivors were recruited from a multicenter collaborative network of clinics, national survivorship groups, and social media. Study participants completed a validated QoL assessment tool that measures four morbidity domains: physical, psychological, social, and spiritual effects. Data were also collected on participant demographics, medical comorbidities, tumor characteristics, and treatment modalities.
  
  
  RESULTS
  A total of 1174 participants with thyroid cancer were recruited. Of these, 89.9% were female, with an average age of 48 years, and a mean time from diagnosis of five years. The mean overall QoL was 5.56/10, with 0 being the worst. Scores for each of the sub-domains were 5.83 for physical, 5.03 for psychological, 6.48 for social, and 5.16 for spiritual well-being. QoL scores begin to improve five years after diagnosis. Female sex, young age at diagnosis, and lower educational attainment were highly predictive of decreased QoL.
  
  
  CONCLUSIONS
  Thyroid cancer diagnosis and treatment can result in a decreased QoL. The present findings indicate that better tools to measure and improve thyroid cancer survivor QoL are needed. The authors plan to follow-up on these findings in the near future, as enrollment and data collection are ongoing.
authors.affiliation: 1 Department of Public Health Sciences, The University of Chicago , Chicago, Illinois.
authors.forename: Briseis
authors.initials: B
authors.lastname: Aschebrook-Kilfoy
authors.affiliation: 2 Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago , Chicago, Illinois.
authors.forename: Benjamin
authors.initials: B
authors.lastname: James
authors.affiliation: 3 Division of Endocrine Surgery, Department of General Surgery, Beaumont Hospitals, Oakland University William Beaumont School of Medicine , Royal Oak, Michigan.
authors.forename: Sapna
authors.initials: S
authors.lastname: Nagar
authors.affiliation: 2 Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago , Chicago, Illinois.
authors.forename: Sharone
authors.initials: S
authors.lastname: Kaplan
authors.affiliation: 2 Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago , Chicago, Illinois.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Seng
authors.affiliation: 1 Department of Public Health Sciences, The University of Chicago , Chicago, Illinois.
authors.forename: Habibul
authors.initials: H
authors.lastname: Ahsan
authors.affiliation: 2 Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago , Chicago, Illinois.
authors.forename: Peter
authors.initials: P
authors.lastname: Angelos
authors.affiliation: 2 Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago , Chicago, Illinois.
authors.forename: Edwin L
authors.initials: EL
authors.lastname: Kaplan
authors.affiliation: 4 Department of Surgery, University of Arizona School of Medicine , Tucson, Arizona.
authors.forename: Marlon A
authors.initials: MA
authors.lastname: Guerrero
authors.affiliation: 5 Division of GI/Endocrine Surgery, Department of Surgery, Columbia University Medical Center , New York, New York.
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Kuo
authors.affiliation: 5 Division of GI/Endocrine Surgery, Department of Surgery, Columbia University Medical Center , New York, New York.
authors.forename: James A
authors.initials: JA
authors.lastname: Lee
authors.affiliation: 6 Department of Surgery and Oncology, University of Rochester Medical Center School of Medicine and Dentistry , Rochester, New York.
authors.forename: Elliot J
authors.initials: EJ
authors.lastname: Mitmaker
authors.affiliation: 7 Department of Surgery, McGill University Health Centre , Montreal, Canada .
authors.forename: Jacob
authors.initials: J
authors.lastname: Moalem
authors.affiliation: 8 Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Ruan
authors.affiliation: 9 Department of Surgery, University of California , San Francisco, San Francisco, California.
authors.forename: Wen T
authors.initials: WT
authors.lastname: Shen
authors.affiliation: 2 Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago , Chicago, Illinois.
authors.forename: Raymon H
authors.initials: RH
authors.lastname: Grogan
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D002170:Canada; D002277:Carcinoma / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D012307:Risk Factors; D012737:Sex Factors; D012919:Social Behavior; D029181:Spirituality; D017741:Survivors; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D014481:United States