BACKGROUND
When someone is diagnosed with cancer, it often brings about a lot of negative emotions and fear. This fear happens largely because people don’t always understand that there are differences between various cancer types and not all cancers are deadly. Patients with thyroid cancer experience fear similar to patients with more aggressive cancers, even though thyroid cancer usually has a very good outlook and has a good chance of being treated successfully.

Strong emotions like fear can affect how we behave and make decisions. Findings from past research suggest that fear related to cancer might lead some patients to choose more complicated treatments than necessary, just to be safe. This can sometimes cause more problems than if they had chosen a less aggressive treatment. To avoid making treatment decisions driven by fear, it is important to understand where this fear comes from and address it. This way, we can help reduce anxiety and make sure that treatment decisions are based on real risks associated with the specific type of cancer.

There hasn’t been a study specifically focusing on fear related to thyroid cancer in the U.S. population. The researchers designed this study to find out how common this fear is among patients with thyroid cancer in the US and identify factors that might be contributing to higher levels of fear.

THE FULL ARTICLE TITLE
Taylor SR et al. Assessing Fear of thyroid cancer in the general U.S. population: A cross-sectional study. Thyroid 2024;34(2):234-242; doi: 10.1089/thy.2023.0479. PMID: 38115606.

SUMMARY OF THE STUDY
The researchers used an online survey platform. They included people over 17 that matched the US Census population in terms of age, gender, and race. Respondents with a history of cancer (other than certain skin cancers) were excluded from the study. The questions were about people’s age, thyroid health, general health, cancer experiences, cancer risk factors, and knowledge about thyroid cancer. To measure fear of thyroid cancer, they used a special scale originally designed for breast cancer. Answers were scored and grouped into low (8-15), moderate (16-23), or high (24-40) levels of fear. The survey also had questions to make sure respondents were paying attention, and those who answered these incorrectly were not included in the results.

There were 1136 respondents who met the inclusion criteria. Half (50%) were women, most (74%) white, and many felt they didn’t know much about thyroid cancer. Overall, 51% overestimated the average lifetime risk of developing thyroid cancer and most (89%) underestimated the overall survival of thyroid cancer.

About half of the respondents (47.5%) had a high level of thyroid cancer fear. These respondents were more likely to be women and younger than 40. They were more likely to feel that they couldn’t do much to prevent thyroid cancer and to automatically think of death when thinking about thyroid cancer.

Respondents with a high level of thyroid cancer fear also tended to think that their risk of getting thyroid cancer was higher than it actually is and were more likely to underestimate how well patients with thyroid cancer actually do compared to respondents who had low or moderate levels of thyroid cancer specific fear.

WHAT ARE THE IMPLICATIONS OF THIS STUDY?
The authors concluded that thyroid cancer-specific fear is common among US adults especially in women and those younger than 40. Most survey respondents had limited knowledge about thyroid cancer. Those who were generally more afraid of cancer tended to have higher fear levels about thyroid cancer, which may be due to the mistaken belief that all cancers are equally dangerous. These findings are important because fear is a strong emotion that can lead to a fight or flight response and can affect how people choose their treatments. This can lead patients to select riskier treatments or even avoid getting checked altogether. Further studies are needed to understand common misconceptions about thyroid cancer, and educational programs are needed to improve thyroid cancer knowledge and to reduce fear before diagnosis.

— Ebru Sulanc, MD

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