Worry about quality of life for younger versus older adult thyroid cancer survivors.
157 Background: Thyroid cancer is one of the most common cancers in young adults, age 18-39 years. Since this population has distinct medical and developmental needs, it is important to understand age differences in worry about quality of life. Methods: Thyroid cancer patients diagnosed between 2014-15 were accrued from the Surveillance, Epidemiology and End Results Program (SEER) registries of Georgia and Los Angeles County and surveyed between 2017-18. The primary outcome was patient reported worry about quality of life. Covariates for this analysis included age (categorized 18-25, 26-39, 40-64, and 65-79), involvement in surgical decision making (low, just right, high) and amount of information received on treatment side effects (low, just right, high). Race/ethnicity, sex, and tumor characteristics were also evaluated. Multivariable analyses were used to assess associations between worry about quality of life and independent variables. Results: In the cohort of 2,632 patients, 39.8% were somewhat to very much worried about quality of life not being the same as before thyroid cancer diagnosis, 15.1% reported low involvement in surgical decision making, and 32.6% reported low amount of information regarding side effects. Younger age was associated with high worry about quality of life (p < 0.001), low involvement in decision making (p < 0.001) and low amount of information on treatment side effects (p < 0.001). In multivariable analyses, high worry was significantly associated with female sex (Odds ratio [OR]: 1.29 95% confidence Interval [CI]:1.04-1.59), non-white, non-Hispanic race/ethnicity (OR: 1.64 CI: 1.38-1.95), positive lymph nodes (OR: 1.41 CI: 1.14-1.75) and younger age (ages 18-25 years OR: 2.34 CI: 1.45-3.76; ages 26-39 years OR: 2.26 CI: 1.68-3.05; and ages 40-64 years OR:1.94 CI 1.50-2.51). Age differences remained significant after adding either involvement in decision-making or information received. Conclusions: Young adults report higher worry about quality of life. Controlling for decision-making involvement or information received about side effects did not eliminate age differences in worry. Ongoing psychosocial support addressing quality of life worries among younger survivors is needed.