Maria Papaleontiou1, Bradley Zebrack2, David Reyes-Gastelum3, Andrew J Rosko4, Sarah T Hawley5, Ann S Hamilton6, Kevin C Ward7, Megan R Haymart8. 1. Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan-North Campus Research Complex, 2800 Plymouth Road, Bldg 16, Rm 453S, Ann Arbor, MI, 48109, USA. 2. School of Social Work, University of Michigan, 1080 S. University, Room 2778, Ann Arbor, MI, 48109, USA. 3. Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan-North Campus Research Complex, 2800 Plymouth Rd., Bldg. 16, 400S-20, Ann Arbor, MI, 48109, USA. 4. Department of Otolaryngology - Head and Neck Surgery, 1904 Taubman Center, 1500 E Medical Center Dr. SPC 5312, Ann Arbor, MI, 48109, USA. 5. Division of General Medicine, Department of Internal Medicine, University of Michigan-North Campus Research Complex, 2800 Plymouth Road, Bldg 16, Rm G034, Ann Arbor, MI, 48109, USA. 6. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto St., SSB318E, MC9239, Los Angeles, CA, 90089-9239, USA. 7. Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd., NE RM 764, GCR Building Mailstop; 1518-002-7AA, Atlanta, GA, 30322, USA. 8. Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan-North Campus Research Complex, 2800 Plymouth Road, Bldg 16, Rm 408E, Ann Arbor, MI, 48109, USA. meganhay@med.umich.edu.
Abstract
PURPOSE: The purpose of this study is to understand physician management of thyroid cancer-related worry. METHODS: Endocrinologists, general surgeons, and otolaryngologists identified by Surveillance, Epidemiology, and End Results (SEER) patients were surveyed 2018-2019 (response rate 69% (448/654)) and asked to rate in general their patients' worry at diagnosis and actions they take for worried patients. Multivariable-weighted logistic regressions were conducted to determine physician characteristics associated with reporting thyroid cancer as "good cancer" and with encouraging patients to seek help managing worry outside the physician-patient relationship. RESULTS: Physicians reported their patients as quite/very worried (65%), somewhat worried (27%), and a little/not worried (8%) at diagnosis. Half of the physicians tell patients their thyroid cancer is a "good cancer." Otolaryngology (odds ratio (OR) 1.87, 95% confidence interval (CI) 1.08-3.21, versus endocrinology), private practice (OR 2.48, 95% CI 1.32-4.68, versus academic setting), and Los Angeles (OR 2.24, 95% CI 1.45-3.46, versus Georgia) were associated with using "good cancer." If patients are worried, 97% of physicians make themselves available for discussion, 44% refer to educational websites, 18% encourage communication with family/friends, 13% refer to support groups, and 7% refer to counselors. Physicians who perceived patients being quite/very worried were less likely to use "good cancer" (OR 0.54, 95% CI 0.35-0.84) and more likely to encourage patients to seek help outside the physician-patient relationship (OR 1.82, 95% CI 1.17-2.82). IMPLICATIONS FOR CANCER SURVIVORS: Physicians perceive patient worry as common and address it with various approaches, with some approaches of unclear benefit. Efforts are needed to develop tailored interventions targeting survivors' psychosocial needs.
PURPOSE: The purpose of this study is to understand physician management of thyroid cancer-related worry. METHODS: Endocrinologists, general surgeons, and otolaryngologists identified by Surveillance, Epidemiology, and End Results (SEER) patients were surveyed 2018-2019 (response rate 69% (448/654)) and asked to rate in general their patients' worry at diagnosis and actions they take for worried patients. Multivariable-weighted logistic regressions were conducted to determine physician characteristics associated with reporting thyroid cancer as "good cancer" and with encouraging patients to seek help managing worry outside the physician-patient relationship. RESULTS: Physicians reported their patients as quite/very worried (65%), somewhat worried (27%), and a little/not worried (8%) at diagnosis. Half of the physicians tell patients their thyroid cancer is a "good cancer." Otolaryngology (odds ratio (OR) 1.87, 95% confidence interval (CI) 1.08-3.21, versus endocrinology), private practice (OR 2.48, 95% CI 1.32-4.68, versus academic setting), and Los Angeles (OR 2.24, 95% CI 1.45-3.46, versus Georgia) were associated with using "good cancer." If patients are worried, 97% of physicians make themselves available for discussion, 44% refer to educational websites, 18% encourage communication with family/friends, 13% refer to support groups, and 7% refer to counselors. Physicians who perceived patients being quite/very worried were less likely to use "good cancer" (OR 0.54, 95% CI 0.35-0.84) and more likely to encourage patients to seek help outside the physician-patient relationship (OR 1.82, 95% CI 1.17-2.82). IMPLICATIONS FOR CANCER SURVIVORS: Physicians perceive patient worry as common and address it with various approaches, with some approaches of unclear benefit. Efforts are needed to develop tailored interventions targeting survivors' psychosocial needs.
Entities:
Keywords:
Good cancer; Oncology; Population-based; Survey; Thyroid cancer; Worry
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