Quality of Life of Survivors of Thyroid Cancer Is Not Inferior to That in Subjects without Cancer: Long-Term after Over 5 Years

Background Patients with thyroid cancer undergo less extensive surgery and additional therapies compared to those with other cancers. We aimed to compare the quality of life (QoL) between patients with thyroid cancer and healthy subjects using representative data from Korea. Differences in QoL of thyroid cancer survivors according to the duration after cancer diagnosis was also evaluated. Methods This population-based cohort study included 50,278 subjects who participated in the Korea National Health and Nutrition Examination Survey between 2007 and 2017. QoL was compared between patients with thyroid cancer and healthy subjects using self-reported data from the EuroQoL (EQ)-5 dimension (5D) and EQ-visual analog scale (VAS). Propensity score matching was used to match thyroid cancer survivors to healthy subjects (1:5 matching). Results Linear regression with univariate analysis showed that the presence of thyroid cancer was positively correlated with better EQ-5D index scores (β-coefficient=0.010, P=0.046). After adjusting for multiple covariables, statistical significance was maintained. EQ-VAS fails to demonstrate any significant correlation. Among the EQ-5D categories, patients with thyroid cancer showed better self-care than healthy subjects. Thyroid cancer duration did not correlate with the EQ-5D index score. In subgroup analyses, compared to patients with thyroid cancer duration of <5 years, no significant difference was observed in the correlation between the EQ-5D index score and survival duration in those with thyroid cancer duration of 5 to 9 years and ≥10 years. Conclusion Using a large-scale nationwide population-based database, our study demonstrated better QoL, especially in terms of self-care, among thyroid cancer survivors than among healthy subjects without cancer.

[1]  U. Megwalu,et al.  Thyroid Cancer Incidence and Mortality Trends in the United States: 2000 - 2018. , 2022, Thyroid : official journal of the American Thyroid Association.

[2]  T. Okamoto,et al.  Fatigue and quality of life among thyroid cancer survivors without persistent or recurrent disease , 2022, Endocrine connections.

[3]  M. Shong,et al.  Effect of Thyroid-Stimulating Hormone Suppression on Muscle Function After Total Thyroidectomy in Patients With Thyroid Cancer , 2021, Frontiers in Endocrinology.

[4]  D. Fuhrer,et al.  2019 European Thyroid Association Guidelines for the Treatment and Follow-Up of Advanced Radioiodine-Refractory Thyroid Cancer , 2019, European Thyroid Journal.

[5]  F. Pitoia,et al.  Dynamic risk assessment in patients with differentiated thyroid cancer. , 2019, Endocrine-related cancer.

[6]  S. Yount,et al.  Clinical factors associated with worse quality-of-life scores in United States thyroid cancer survivors. , 2019, Surgery.

[7]  S. Yount,et al.  Post-thyroidectomy neck appearance and impact on quality of life in thyroid cancer survivors. , 2019, Surgery.

[8]  E. Lee,et al.  Prediction of Cancer Incidence and Mortality in Korea, 2019 , 2019, Cancer research and treatment : official journal of Korean Cancer Association.

[9]  E. Cvejic,et al.  Health-Related Quality of Life After Diagnosis and Treatment of Differentiated Thyroid Cancer and Association With Type of Surgical Treatment , 2019, JAMA otolaryngology-- head & neck surgery.

[10]  K. Devon,et al.  Differences in long-term quality of life between hemithyroidectomy and total thyroidectomy in patients treated for low-risk differentiated thyroid carcinoma. , 2019, Surgery.

[11]  C. Bădulescu,et al.  Psychological impact of 131I radioprotection measures on thyroid cancer patients , 2018, Clujul medical.

[12]  C. Jimeno,et al.  Validity and Reliability of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 – Tagalog among Adult Filipinos with Differentiated Thyroid Cancer* , 2018, Journal of the ASEAN Federation of Endocrine Societies.

[13]  D. Yin,et al.  The association between thyroid cancer and insulin resistance, metabolic syndrome and its components: A systematic review and meta-analysis. , 2018, International journal of surgery.

[14]  Yan-jun Ren,et al.  Health-Related Quality of Life of Community Thyroid Cancer Survivors in Hangzhou, China. , 2018, Thyroid : official journal of the American Thyroid Association.

[15]  Ken R. Smith,et al.  Risk Factors for Cardiovascular Disease Among Thyroid Cancer Survivors: Findings From the Utah Cancer Survivors Study , 2018, The Journal of clinical endocrinology and metabolism.

[16]  N. Tolley,et al.  Quality of life in differentiated thyroid cancer. , 2017, International journal of surgery.

[17]  Ken R. Smith,et al.  Aging-Related Disease Risks among Young Thyroid Cancer Survivors , 2017, Cancer Epidemiology, Biomarkers & Prevention.

[18]  Kyu-Won Jung,et al.  Prediction of Cancer Incidence and Mortality in Korea, 2017 , 2017, Cancer research and treatment : official journal of Korean Cancer Association.

[19]  Kaliszewski,et al.  American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer : The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer , 2017 .

[20]  M. Jung,et al.  Post-treatment cognitive dysfunction in women treated with thyroidectomy for papillary thyroid carcinoma , 2017, Supportive Care in Cancer.

[21]  R. Peeters,et al.  Thyroid hormone and its metabolites in relation to quality of life in patients treated for differentiated thyroid cancer , 2016, Clinical endocrinology.

[22]  K. Yi The Revised 2016 Korean Thyroid Association Guidelines for Thyroid Nodules and Cancers: Differences from the 2015 American Thyroid Association Guidelines , 2016, Endocrinology and metabolism.

[23]  A. Jemal,et al.  Cancer treatment and survivorship statistics, 2016 , 2016, CA: a cancer journal for clinicians.

[24]  G. Fattore,et al.  A comparison of EuroQol 5-Dimension health-related utilities using Italian, UK, and US preference weights in a patient sample , 2016, ClinicoEconomics and outcomes research : CEOR.

[25]  P. Perros,et al.  Management of thyroid cancer: United Kingdom National Multidisciplinary Guidelines , 2016, The Journal of Laryngology &#x0026; Otology.

[26]  Nan Luo,et al.  The EQ-5D-5L valuation study in Korea , 2016, Quality of Life Research.

[27]  M. Schlumberger,et al.  Quality of Life and Cost-Effectiveness Assessment of Radioiodine Ablation Strategies in Patients With Thyroid Cancer: Results From the Randomized Phase III ESTIMABL Trial. , 2015, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[28]  Joanna Waligórska-Stachura,et al.  ThyPROpl--The Polish version of the thyroid-specific quality of life questionnaire ThyPRO. , 2015, Endokrynologia Polska.

[29]  H. Y. Kim,et al.  A prospective comparison of patient body image after robotic thyroidectomy and conventional open thyroidectomy in patients with papillary thyroid carcinoma. , 2014, Surgery.

[30]  T. Kwon,et al.  Comparison of health-related quality of life between cancer survivors treated in designated cancer centers and the general public in Korea. , 2014, Japanese journal of clinical oncology.

[31]  Jian-kui Han,et al.  Thyroid tumor-initiating cells: Increasing evidence and opportunities for anticancer therapy (Review) , 2014, Oncology reports.

[32]  M. B. Gillespie,et al.  Salivary Morbidity and Quality of Life following Radioactive Iodine for Well-Differentiated Thyroid Cancer , 2013, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[33]  R. Kloos,et al.  In thyroidectomized patients with thyroid cancer, a serum thyrotropin of 30 μU/mL after thyroxine withdrawal is not always adequate for detecting an elevated stimulated serum thyroglobulin. , 2013, Thyroid : official journal of the American Thyroid Association.

[34]  L. V. van de Poll-Franse,et al.  Development of a disease-specific health-related quality of life questionnaire (THYCA-QoL) for thyroid cancer survivors , 2013, Acta oncologica.

[35]  A. Hinz,et al.  Quality of life in patients with thyroid cancer compared with the general population. , 2012, Thyroid : official journal of the American Thyroid Association.

[36]  G. Pentheroudakis,et al.  Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. , 2010, Annals of oncology : official journal of the European Society for Medical Oncology.

[37]  Andrew Lloyd,et al.  Health Utilities Using the EQ-5D in Studies of Cancer , 2012, PharmacoEconomics.

[38]  Soo Hyun Kim,et al.  Decreased health-related quality of life in disease-free survivors of differentiated thyroid cancer in Korea , 2010, Health and quality of life outcomes.

[39]  Paul Kind,et al.  South Korean time trade-off values for EQ-5D health states: modeling with observed values for 101 health states. , 2009, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[40]  C. Benbassat,et al.  Illness perception in patients with differentiated epithelial cell thyroid cancer. , 2009, Thyroid : official journal of the American Thyroid Association.

[41]  L. Krook,et al.  Symptomatic hyponatremia in association with a low-iodine diet and levothyroxine withdrawal prior to I131 in patients with metastatic thyroid carcinoma. , 2008, Thyroid : official journal of the American Thyroid Association.

[42]  J. Romijn,et al.  Quality of life in cured patients with differentiated thyroid carcinoma. , 2008, The Journal of clinical endocrinology and metabolism.

[43]  J. Thumboo,et al.  Health‐Related Quality of Life in Thyroid Cancer Survivors , 2007, The Laryngoscope.

[44]  B. Weintraub,et al.  A comparison of short-term changes in health-related quality of life in thyroid carcinoma patients undergoing diagnostic evaluation with recombinant human thyrotropin compared with thyroid hormone withdrawal. , 2006, The Journal of clinical endocrinology and metabolism.

[45]  Jeroen J. Bax,et al.  Quality of life in longterm exogenous subclinical hyperthyroidism and the effects of restoration of euthyroidism, a randomized controlled trial , 2006, Clinical endocrinology.

[46]  A. Bockisch,et al.  Health-related Quality of Life, Depression and Anxiety in Thyroid Cancer Patients , 2006, Quality of Life Research.

[47]  F. Minuto,et al.  A case-controlled study on the quality of life in a cohort of patients with history of differentiated thyroid carcinoma , 2005, Journal of endocrinological investigation.

[48]  S. Bae,et al.  Cross-cultural adaptation and validation of the Korean version of the EQ-5D in patients with rheumatic diseases , 2005, Quality of Life Research.

[49]  L. Chien,et al.  Postoperative quality of life among patients with thyroid cancer. , 2004, Journal of advanced nursing.

[50]  M. Wolzt,et al.  Quality of life in patients with non-metastatic differentiated thyroid cancer under thyroxine supplementation therapy , 2003, Supportive Care in Cancer.

[51]  P. Schultz,et al.  Health profiles and quality of life of 518 survivors of thyroid cancer , 2003, Head & neck.

[52]  Shinichiro,et al.  Carcinoma , 1906, The Hospital.