BACKGROUND To the authors' knowledge, studies regarding risk perception among survivors of thyroid cancer are scarce. METHODS The authors surveyed patients who were diagnosed with differentiated thyroid cancer from the Surveillance, Epidemiology, and End Results registries of Georgia and Los Angeles County (2632 patients; 63% response rate). The analytic cohort was defined by a ≤5% risk of disease recurrence and mortality (1597 patients). Patients estimated their recurrence and mortality risks separately (increments of 10% and endpoints of ≤5% and ≥95%). Both outcomes were dichotomized between reasonably accurate estimates (risk perception of ≤5% or 10%) versus overestimation (risk perception of ≥20%). Multivariable logistic regression was used to identify factors associated with risk overestimation, and the relationships between overestimation and both worry and quality of life were evaluated. RESULTS In the current study sample, 24.7% of patients overestimated their recurrence risk and 12.5% overestimated their mortality risk. A lower educational level was associated with overestimating disease recurrence (≤high school diploma: odds ratio [OR], 1.64 [95% CI, 1.16-2.31]; and some college: OR, 1.36 [95% CI, 1.02-1.81]) and mortality (≤high school diploma: OR, 1.86 [95% CI, 1.18-2.93]) risk compared with those attaining at least a college degree. Hispanic ethnicity was found to be associated with overestimating recurrence risk (OR, 1.44, 95% CI 1.02-2.03) compared with their white counterparts. Worry about recurrence and death was found to be greater among patients who overestimated versus those who had a reasonably accurate estimate of their risk of disease recurrence and mortality, respectively (P < .001). Patients who overestimated mortality risk also reported a decreased physical quality of life (mean T score, 43.1; 95% CI, 41.6-44.7) compared with the general population. CONCLUSIONS Less educated patients and Hispanic patients were more likely to report inaccurate risk perceptions, which were associated with worry and a decreased quality of life.

中文翻译：

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甲状腺癌复发和死亡的风险认知存在差异。


背景 据作者所知，关于甲状腺癌幸存者风险认知的研究很少。方法 作者对佐治亚州和洛杉矶县的监测、流行病学和最终结果登记处诊断为分化型甲状腺癌的患者进行了调查（2632 名患者；63% 的缓解率）。分析队列的定义是疾病复发和死亡风险≤5%（1597 名患者）。患者分别估计其复发和死亡风险（增量为 10%，终点为 ≤5% 和 ≥95%）。两种结果均分为合理准确的估计（风险感知≤5%或10%）与高估（风险感知≥20%）。使用多变量逻辑回归来识别与风险高估相关的因素，并评估高估与担忧和生活质量之间的关系。结果 在当前的研究样本中，24.7% 的患者高估了其复发风险，12.5% 高估了其死亡风险。较低的教育水平与高估疾病复发相关（≤高中文凭：比值比 [OR]，1.64 [95% CI，1.16-2.31]；某些大学：OR，1.36 [95% CI，1.02-1.81]）与至少获得大学学位的人相比，死亡率（≤高中文凭：OR，1.86 [95% CI，1.18-2.93]）风险。与白人相比，西班牙裔种族被发现与高估复发风险相关（OR，1.44，95% CI 1.02-2.03）。研究发现，高估疾病复发和死亡风险的患者与对疾病复发和死亡风险有相当准确估计的患者相比，对复发和死亡的担忧更大（P < .001）。 与一般人群相比，高估死亡风险的患者的身体生活质量也有所下降（平均 T 评分，43.1；95% CI，41.6-44.7）。结论 受教育程度较低的患者和西班牙裔患者更有可能报告不准确的风险认知，这与担忧和生活质量下降有关。