Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.
Educational Objective: Identify factors linked to inadequate social and emotional support in thyroid cancer survivors.
Objectives: Anxiety and depression are elevated in thyroid cancer survivors, but factors contributing to inadequate support and poor mental health are unclear.
Study Design: Cross-sectional survey.
Methods: Adults from the 2022-2023 Behavioral Risk Factor Surveillance System (BRFSS) survey who completed Cancer Survivorship and Social Determinants and Health Equity modules were included. Participants self-reported cancer history, type, treatment status, and adequacy of social/emotional support. Prevalence estimates were calculated using survey weights. Multivariable regression was applied to assess factors associated with support and mental health reports.
Results: Of 472,993 respondents (498 with thyroid cancer), 54.2% [95% CI: 47.1-61.1%] of thyroid cancer survivors reported always receiving needed support compared to 52.0% [95% CI: 51.0-53.0%] of other cancer survivors and 46.4% [95% CI: 46.0-47.0%] of individuals without cancer. Factors significantly linked to inadequate support included being unmarried (OR: 4.37 [95% CI: 1.34-14.26]) and recent employment loss/reduction (OR: 6.90 [95% CI: 1.27-37.35]). Age over 65 years was associated with lower odds of inadequate support (OR: 0.35 [95% CI: 0.11-1.10]), though not significantly so. Sex, race, education, income, insurance, and treatment status were not significantly associated with inadequate social and emotional support. Self-report of inadequate social and emotional support was strongly tied to more days feeling depressed or anxious (OR: 3.18 [95% CI: 1.05-9.61]).
Conclusions: Unmarried status and employment changes are linked to inadequate social/emotional support in thyroid cancer survivors, which in turn is associated with worse mental health outcomes. Otolaryngologists must consider these risk factors as they seek to provide optimal care for thyroid cancer patients. Referrals to social work, psychology and support groups should be provided to this patient demographic to optimize their post-operative care.