College of Nursing, Chungnam National University, Daejeon, South Korea.
School of Nursing Eastern, Michigan University, 318T Porter Building, Ypsilanti, MI, 48197, USA.
Support Care Cancer. 2022 Nov;30(11):8959-8967. doi: 10.1007/s00520-022-07299-6. Epub 2022 Aug 3.
The study aims to assess cognitive function in women newly diagnosed with non-metastatic thyroid cancer before any treatment and to identify factors associated with cognitive problems.
Korean women newly diagnosed with thyroid cancer awaiting initial surgical treatment (n = 130) completed neuropsychological tests and self-report questionnaires on symptom distress and psychological distress. Additionally, information on thyroid function was obtained through a medical chart audit. Descriptive statistics and multivariable regression analyses were performed to describe the incidence of cognitive problems and to identify possible predictors of neuropsychological performance.
Approximately 95% of women newly diagnosed with thyroid cancer had impaired neuropsychological test scores on one or more tests of attention and cognitive control. Further analyses found that 78% of women met both the Global Deficit Score and the International Cancer and Cognition Task Force criteria for impairment. Finally, regression analyses found that older age, fewer years of education, greater depressed mood, and having a hypothyroid state but not having a comorbid condition, fatigue, sleep problems, symptom burden, or symptom interference were associated with worse neuropsychological test performance in this sample. Additional explorative regression analysis using mean T-scores corrected for age, education, and gender continued to find that hypothyroid state was associated with worse neuropsychological test performance.
Findings suggest that individuals newly diagnosed with non-metastatic thyroid cancer are vulnerable to cognitive deficits at diagnosis before any treatment. As such, healthcare workers should assess individuals newly diagnosed with thyroid cancer diagnosis awaiting treatment for the disease for cognitive deficits and intervene to reduce symptom distress and optimize function.
本研究旨在评估新诊断为非转移性甲状腺癌的女性在任何治疗前的认知功能，并确定与认知问题相关的因素。
等待初始手术治疗的韩国新诊断为甲状腺癌的女性（n=130）完成了神经心理学测试和症状困扰及心理困扰的自我报告问卷。此外，通过病历审核获得了甲状腺功能的信息。描述性统计和多变量回归分析用于描述认知问题的发生率，并确定神经心理学表现的可能预测因素。
约 95%的新诊断为甲状腺癌的女性在一项或多项注意力和认知控制测试中存在神经心理学测试分数受损。进一步的分析发现，78%的女性同时符合全球缺陷评分和国际癌症和认知任务组的损伤标准。最后，回归分析发现，年龄较大、受教育年限较少、抑郁情绪更严重、甲状腺功能减退状态但无合并症、疲劳、睡眠问题、症状负担或症状干扰与该样本的神经心理学测试表现较差相关。使用年龄、教育程度和性别校正的平均 T 评分进行的额外探索性回归分析继续发现，甲状腺功能减退状态与神经心理学测试表现较差相关。
研究结果表明，在接受任何治疗之前，新诊断为非转移性甲状腺癌的个体在诊断时就容易出现认知缺陷。因此，医疗保健工作者应评估新诊断为甲状腺癌且正在等待治疗的患者是否存在认知缺陷，并采取干预措施减轻症状困扰，优化功能。
