Background: There is a lack of health-related quality of life (HRQOL) research in thyroid cancer (TC) survivors, especially young adults (YAs). This study aims to assess the socio-demographic and clinical factors that most influence TC-specific QOL domains and estimate the impact of different health conditions on HRQOL in a large cohort of YA TC survivors.
Methods: TC survivors ≥17 years of age were recruited through the thyroid cancer survivor (ThyCa) Web site. Mean scores for the seven domains and six items of THYCA-QoL, MCS and PCS of SF-12v1, and derived SF-6D were compared between factors as well as age groups (YA: 17-39 years, adult ≥40 years), and to the normal population. Regression analyses estimated the relationship between the socio-demographic, clinical, and THYCA-QoL measures and HRQOL in YAs only.
Results: Of 1028 survivors, 277 (27%) were YAs. Most YAs were female (93.5%), white (86.6%), insured (96.8%), married or in a stable relationship (69%), and listed a comorbidity (43.7%); all reported their entire thyroid had been removed. Average survivorship time was 46.2 months (SD = 51.0). Almost every socio-demographic and clinical factor significantly influenced one or more domain of THYCA-QoL in both YAs and older adults. In both groups, a higher level of education, female sex, unemployment, and having a comorbidity resulted in significantly higher THYCA-QoL scores (more complaints) and lower SF-6D scores (lower HRQOL; p < 0.05). Current YAs had less neuromuscular, voice, sympathetic, and throat/mouth complaints but more grievances involving their scar, headaches, anxiety, and overall psychological state (p < 0.05). The average SF-6D for YAs was 0.70 (SD = 0.13), which was similar to the older adults but significantly different from the normal age-matched population in females (p < 0.01). All THYCA-QoL domains were strongly associated with a lower HRQOL (adj R(2) > 0.5) in YAs. The simplest, best regression model (adj R(2) = 0.53) in YAs included neuromuscular, concentration, and anxiety complaints, as well as having a comorbidity predicting lower HRQOL.
Conclusion: TC-specific QOL is significantly influenced by many socio-demographic and clinical factors. HRQOL is lower in female YA TC survivors compared with the normal age-matched population. Neuromuscular, concentration, and anxiety complaints had the greatest impact on HRQOL in YA TC survivors.