Psychiatric History May Prompt Patients’ Decisions for Faster Surgical Treatment in Thyroid Cancer

Patients with anxiety, as well as anxiety and depression, may turn to surgical treatment faster than considering active surveillance when discussing treatment options, highlighting the need for further physician counseling, according to a poster presentation at the 91st Annual Meeting of the American Thyroid Association.

“A thyroid cancer diagnosis is associated with significant psychological distress comparable to that of squamous cell head and neck cancer patients and this may prompt patients to seek definitive and urgent surgical care instead of considering active surveillance,” Dragan Vujovic, BA, Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, said in a presentation of the data. “It is important to reconsider this in context with the spike in mental illness in recent years in the United States.”

In the retrospective chart review, the researchers aimed to determine the impact of pre-existing anxiety or depression on surgical decision-making for thyroid cancer. The analysis was conducted on 423 patients aged ≥18 years with non-recurrent thyroid cancer using a database of patients with newly diagnosed and surgically treated thyroid cancer at Mount Sinai Hospital between 2018 and 2019.

Overall, 11% of patients had anxiety, 12% had depression, and 7% had anxiety and depression.

The researchers then evaluated psychiatric history and time to treatment. Patients with anxiety, vs those without, showed a shorter mean time to treatment (53.5 days vs 86.6 days, respectively; P = .007). Similarly, those with anxiety and depression, compared with those without anxiety or depression, demonstrated a shorter mean time to treatment (57.1 days vs 84.4 days, respectively; P = .041). However, depression alone was not a statistically significant predictor of time to treatment (58.9 days vs 85.4 days, respectively; P = .058).

After adjusting for age, sex, race, insurance type, family history of thyroid cancer, number of comorbidities, smoking status, and BMI, anxiety (P = .207), depression (P = .372), and anxiety and depression (P = .484) were not associated with shorter time to treatment.

“And so, psychiatric history may be an important factor for physicians to consider when counseling patients with thyroid cancer,” Vujovic concluded.

_Reference:

_{Vujovic D, Yeshoua B, Vasan V, et al. Anxiety and depression as potential predictors for shorter time to initial surgical treatment of thyroid cancer. Thyroid. 2022;32(1):P-1-A-135. doi:10.1089/thy.2022.29137.abstracts.}