Health-related quality of life in cancer survivors 5 years after total thyroidectomy: a population-based study

Abstract

Abstract Context Long-term data on thyroid cancer survivors (TCS), a population experiencing persistent physical and mental health-related quality of life (HRQoL) impairment, are limited. Patients and Methods Thyroid cancer survivors diagnosed in 2010-2011 were randomly selected from the French National Insurance database. Clinical data on consenting participants were retrieved from medical files while Physical and Mental Component Summary (PCS/MCS) HRQoL scores were calculated using the SF-12 questionnaire 2 and 5 years post-diagnosis. Health-related quality of life impairment was defined using reference values for the French general population. We compared HRQoL with both the general population and patients with other common cancers having good prognoses. Logistic regression identified factors associated with impaired HRQoL. Results Of the 130 survivors reporting HRQoL 5 years post-diagnosis, 83.8% were women, 97.6% had undergone total thyroidectomy, and mean age was 40 years. Physical and mental HRQoL impairment was observed in 49% and 41% of participants, respectively, figures comparable to or exceeding those in survivors of other common cancers with good prognoses. Age- and sex-standardized PCS and MCS z-scores were −0.34 [−0.52 to −0.16] and −0.51 [−0.69 to −0.34], respectively (P < .001). The PCS and MCS scores remained stable (71.8% and 75.3% of the sample, respectively), with 11.8% and 5.9%, respectively, experiencing a deterioration. Lower educational levels, anxiety, and activity limitation were associated with physical HRQoL impairment, whereas male sex was associated with mental impairment. Body image discomfort was associated with impairment for both domains. Conclusion Persistent HRQoL impairment among TCS 5 years post-diagnosis highlights the need for personalized, long-term care strategies.