Department of Otolaryngology Head and Neck Surgery, Rennes University Hospital, 35000, Rennes, France.
UMR 912 SESSTIM (INSERM), Marseille, France.
Support Care Cancer. 2022 Mar;30(3):2777-2785. doi: 10.1007/s00520-021-06715-7. Epub 2021 Nov 27.
Thyroid cancer (TC) incidence is increasing. With its good prognosis and the young population concerned, the number of survivors is rising. However, their quality of life appears worse than expected. This study aims to assess the social and sexual health (SSH) of TC survivors and associated factors after a 2- and 5-year follow-up.
This study belongs to the National VICAN Survey implemented in France among TC patients diagnosed between January and June 2010. Data were collected via phone interviews, medical surveys, and from medico-administrative register in 2012 and 2015. We used multivariable logistic regressions to qualify TC impact on SSH.
Across 146 patients, 121 were women, 50.7% were less than 42 years old, 77.5% were diagnosed at an early-stage, and 97.6% underwent thyroidectomy. At 2 years, 60.0% experienced social life discomfort because of cancer, 40.6% reported a decreased sexual desire, 37.4% fewer intercourse, 31.9% felt dissatisfied with this frequency, 30% reported difficulties achieving orgasm, and 15.2% considered that cancer had a negative influence for procreation. No significant difference was observed at 5 years. SSH was never discussed with medical professionals for 96.7% patients, as it was not proposed as a topic of concern (79.1%). In multivariable analysis, depression, embarrassment regarding their physical appearance since treatment, and reduced gestures of affection remained associated with decreased sexual desire.
This study highlights that TC is associated with an alteration of SSH which remains even at 5 years post-diagnosis. SSH should be discussed during diagnosis and considered during follow-up.
甲状腺癌（TC）的发病率正在上升。由于其预后良好，且涉及到年轻人群，因此患者人数不断增加。然而，他们的生活质量似乎不如预期。本研究旨在评估 TC 幸存者在诊断后 2 年和 5 年的随访中的社会和性健康（SSH）及其相关因素。
本研究属于法国全国 VICAN 调查的一部分，该调查于 2010 年 1 月至 6 月期间在 TC 患者中进行。数据通过电话访谈、医疗调查以及 2012 年和 2015 年的医疗行政记录收集。我们使用多变量逻辑回归来确定 TC 对 SSH 的影响。
在 146 名患者中，有 121 名是女性，50.7%的患者年龄小于 42 岁，77.5%的患者诊断为早期，97.6%的患者接受了甲状腺切除术。在 2 年时，60.0%的患者因癌症而感到社交生活不适，40.6%的患者报告性欲下降，37.4%的患者性生活减少，31.9%的患者对这一频率感到不满，30%的患者报告难以达到性高潮，15.2%的患者认为癌症对生育有负面影响。在 5 年时未观察到显著差异。96.7%的患者从未与医疗专业人员讨论过 SSH，因为 SSH 未被视为关注的话题（79.1%）。在多变量分析中，抑郁、治疗后对自己外表的尴尬以及减少表示爱意的动作与性欲下降相关。
本研究强调 TC 与 SSH 的改变有关，即使在诊断后 5 年仍存在。SSH 应在诊断期间讨论，并在随访期间考虑。
