title: Assessment of anxiety levels of patients awaiting surgery for suspected thyroid cancer: A case-control study in a Chinese-Han population.
abstract: BACKGROUND
  The objective of this study was to evaluate levels and prevalence of anxiety in thyroid tumor patients awaiting surgery and diagnosis and to investigate whether significant differences existed in preoperative anxiety levels between patients with postoperative pathological diagnosis of benign thyroid tumors (BTT) or thyroid cancer (TC) in a Chinese-Han population.
  
  
  METHODS
  Five hundred and twenty-nine patients awaiting surgery and diagnosis were chosen as the patient group, and 419 healthy Chinese were chosen as the control group. Anxiety levels were assessed by the State-Trait Anxiety Inventory.
  
  
  RESULTS
  The cytological and histopathologic examinations showed BTT in 390 patients and TC in 139 patients. Moderate and high state-anxiety prevalence were 63.3%, 66.9%, and 38.9%, and moderate and high trait-anxiety prevalence were 53.6%, 56.1%, and 20.5% for BTT, TC, and healthy groups, respectively. There were significant differences in sample distributions between low and moderate/high anxiety levels among the three groups (state-anxiety, χ2= 60.95, P < 0.001; trait-anxiety, χ2= 111.73, P < 0.001). The mean state-anxiety scores were 41.02 ± 8.82, 42.71 ± 8.74, and 37.18 ± 7.46, and the mean trait-anxiety scores were 41.91 ± 8.40, 42.69 ± 9.40, and 38.28 ± 6.30 for BTT, TC, and healthy groups, respectively. There were significant differences in the state-anxiety (χ2= 73.43, P < 0.001) and trait-anxiety levels (χ2= 72.21, P < 0.001) among these three groups.
  
  
  CONCLUSIONS
  This study has demonstrated that patients with BTT or TC have a high level of anxiety. The anxiety level of patients with TC is significantly higher than those with BTT. Our results indicate that anxiety may be a relative risk of thyroid tumor in Han-Chinese. © 2016 John Wiley & Sons Australia, Ltd.
authors.affiliation: Department of Thyroid Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Center for Mental Health, Yanshan University, Qinhuangdao, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Ma
authors.affiliation: Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Man
authors.initials: M
authors.lastname: Wang
authors.affiliation: Clinical Nursing Section, The First Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Aiping
authors.initials: A
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D015995:Prevalence; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery*; D055815:Young Adult
keywords: Chinese; anxiety; pre-surgery; thyroid cancer; thyroid tumor