Bresner Lauren, Banach Rita, Rodin Gary, Thabane Lehana, Ezzat Shereen, Sawka Anna M
Division of Endocrinology (L.B.), Department of Medicine, Toronto General Hospital, Toronto, ON M5G 2C4, Canada; Thyroid Cancer Canada (R.B.), Toronto, ON M5N 3A8, Canada; Department of Psychosocial Oncology (G.R.), Princess Margaret Hospital, Toronto, ON M5G 2M9, Canada; Department of Clinical Epidemiology and Biostatistics (L.T.), St. Joseph's Healthcare and McMaster University, Hamilton, ON L8N 4A6, Canada; and Division of Endocrinology (S.E., A.M.S.), University Health Network and University of Toronto, Toronto, ON M5G 2N2, Canada.
J Clin Endocrinol Metab. 2015 Mar;100(3):977-85. doi: 10.1210/jc.2014-3169. Epub 2014 Nov 13.
Little is known about cancer-related worry in thyroid cancer survivors.
We quantified cancer-related worry in Canadian thyroid cancer survivors and explored associated factors.
DESIGN, SETTING, AND PARTICIPANTS: We performed a cross-sectional, self-administered, written survey of thyroid cancer survivor members of the Thyroid Cancer Canada support group. Independent factors associated with cancer-related worry were identified using a multivariable linear regression analysis.
We used the Assessment of Survivor Concerns (ASC) questionnaire, which includes questions on worry about diagnostic tests, second primary malignancy, recurrence, dying, health, and children's health.
The response rate for eligible members was 60.1% (941 of 1567). Most respondents were women (89.0%; 837 of 940), and the age was < 50 years in 54.0% of participants (508 of 941). Thyroid cancer was diagnosed within ≤ 5 years in 66.1% of participants (622 of 940). The mean overall ASC score was 15.34 (SD, 4.7) (on a scale from 6 [least worry] to 24 [most worry]). Factors associated with increased ASC score included: younger age (P < .001), current suspected or proven recurrent/persistent disease (ie, current proven active disease or abnormal diagnostic tests) (P < .001), partnered marital status (P = .021), having children (P = .029), and ≤5 years since thyroid cancer diagnosis (P = .017).
In a population of Canadian thyroid cancer survivors, cancer-related worry was greatest in younger survivors and those with either confirmed or suspected disease activity. Family status and time since thyroid cancer diagnosis were also associated with increased worry. More research is needed to confirm these findings and to develop effective preventative and supportive strategies for those at risk.
甲状腺癌幸存者中与癌症相关的担忧情况鲜为人知。
我们对加拿大甲状腺癌幸存者中与癌症相关的担忧进行了量化，并探讨了相关因素。
设计、背景和参与者：我们对加拿大甲状腺癌支持小组的甲状腺癌幸存者成员进行了一项横断面、自我管理的书面调查。使用多变量线性回归分析确定与癌症相关担忧相关的独立因素。
我们使用了幸存者担忧评估（ASC）问卷，其中包括有关对诊断检查、第二原发性恶性肿瘤、复发、死亡、健康和儿童健康的担忧的问题。
符合条件成员的回复率为60.1%（1567人中的941人）。大多数受访者为女性（89.0%；940人中的837人），54.0%的参与者（941人中的508人）年龄小于50岁。66.1%的参与者（940人中的622人）在≤5年内被诊断出甲状腺癌。ASC总分的平均值为15.34（标准差，4.7）（范围为6[最不担忧]至24[最担忧]）。与ASC评分增加相关的因素包括：年龄较小（P<.001）、目前怀疑或已证实的复发/持续性疾病（即目前已证实的活动性疾病或异常诊断检查）（P<.001）、已婚婚姻状况（P=.021）、有子女（P=.029）以及自甲状腺癌诊断以来≤5年（P=.017）。
在加拿大甲状腺癌幸存者群体中，与癌症相关的担忧在年轻幸存者以及那些有确诊或疑似疾病活动的人中最为严重。家庭状况和自甲状腺癌诊断以来的时间也与担忧增加有关。需要更多研究来证实这些发现，并为有风险的人群制定有效的预防和支持策略。
