Cancer

Background Studies on risk perception among thyroid cancer survivors are scarce. Methods We surveyed patients with differentiated thyroid cancer from Surveillance, Epidemiology and End Results registries of Georgia and Los Angeles (N=2632; 63% response rate). Analytic cohort was defined by ≤5% risk of recurrence and mortality (N=1597). Patients estimated recurrence and mortality risk separately (increments of 10% and endpoints ≤5% and ≥95%). Both outcomes were dichotomized between reasonably accurate estimate (risk perception ≤5% or 10%) versus overestimation (risk perception ≥20%). We used multivariable logistic regression to identify factors associated with risk overestimation, and evaluated the relationships between overestimation and both worry and quality of life. Results In this sample, 24.7% overestimated recurrence risk and 12.5% overestimated mortality risk. Lower education was associated with overestimating recurrence (high school diploma and below: odds ratio (OR) 1.64, 95% confidence interval (CI) 1.16–2.31; some college: OR 1.36, 95% CI 1.02–1.81) and mortality risk (high school diploma and below: OR 1.86, 95% CI 1.18–2.93) compared to college degree and above. Hispanic ethnicity was associated with overestimating recurrence risk (OR 1.44, 95% CI 1.02–2.03) compared to whites. Worry about recurrence and death was greater among patients who overestimated versus had reasonably accurate estimate of recurrence and mortality risk, respectively (p<0.001). Patients who overestimated mortality risk also reported decreased physical quality of life (mean T-score 43.1, 95% CI 41.6–44.7) compared to general population. Conclusion Less educated and Hispanic patients were more likely to report inaccurate risk perceptions, which were associated with worry and decreased quality of life.

31869452

PMC7178109

CDC Public Access