title: Determinants of long-term quality of life in patients with differentiated thyroid carcinoma - a population-based cohort study in Sweden.
abstract: BACKGROUND
  Although differentiated thyroid cancer (DTC) has an excellent prognosis and a low incidence of recurrence, lifelong follow-up and medication might be needed. The aim of this study was to clarify how living with a cancer diagnosis for many years affects health-related quality of life (HRQoL) in DTC patients in Sweden.
  
  
  METHODS
  From the national all-encompassing population-based Swedish Cancer Registry, 353 patients diagnosed with DTC between 1995 and 1998 were identified and invited to answer the HRQoL questionnaire SF-36 and a study-specific questionnaire, 14-17 years after their diagnosis. Data were compared with a reference population as well between subgroups of patients.
  
  
  RESULTS
  Of the patients with DTC, 279 (79%) answered the questionnaires. In all, only 19 (7%) reported a recurrence, however, as many as 134 (48%) stated that they still had concerns about having a recurrence. The HRQoL in those with a recurrence was significantly lower than those without concerns of a recurrence in five of eight domains (p < 0.001-0.049). Similarly, patients with concerns of a recurrence reported poorer HRQoL than those without concerns, with significantly lower values in five domains (p < 0.001-0.008). Those few who stated that their disease had given them a negative view on life reported poor HRQoL in all eight domains (p < 0.001-0.030).
  
  
  CONCLUSIONS
  Even if DTC comes with an excellent prognosis, almost half of the patients, fully 15 years after diagnosis, worried about a recurrence which negatively impacted their HRQoL. Awareness among healthcare practitioners might improve information, supportive care and, in the end, the patient's HRQoL.
authors.affiliation: a Department of Molecular Medicine and Surgery , Karolinska Institutet , Stockholm , Sweden ;|d Stockholms Sjukhem Foundation , Stockholm , Sweden.
authors.forename: Christel
authors.initials: C
authors.lastname: Hedman
authors.affiliation: b Department of Medicine , Solna, Karolinska Institutet , Stockholm , Sweden ;
authors.forename: Therese
authors.initials: T
authors.lastname: Djärv
authors.affiliation: c Department of Oncology-Pathology , Karolinska Institutet , Stockholm , Sweden ;|d Stockholms Sjukhem Foundation , Stockholm , Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Strang
authors.affiliation: a Department of Molecular Medicine and Surgery , Karolinska Institutet , Stockholm , Sweden ;
authors.forename: Catharina Ihre
authors.initials: CI
authors.lastname: Lundgren
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D000328:Adult; D002454:Cell Differentiation; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D011379:Prognosis; D011788:Quality of Life; D011795:Surveys and Questionnaires; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*