Many controversies exist regarding screening and treatment of thyroid cancer (TC), especially papillary thyroid microcarcinoma (PTMC). The aim of this study was to evaluate patients' psychological distress and sleep disturbance throughout thyroid nodules (TNs) screening, diagnosis and treatment.A total of 2834 participants (1153 participants with TNs) were enrolled during the screening phase, and 1105 individuals with TNs (87 individuals with TC) were enrolled during the diagnosis phase. Of the 87 TC patients, 66 underwent immediate operation (OP), and 21 patients with PTMC opted for active surveillance (AS). Four validated scales were applied to quantify the outcome indicators at prescreening, postscreening, postdiagnosis and posttreatment.Higher psychological distress and sleep disturbance were found postscreening than prescreening in subjects with TNs, but no differences in those absence of nodules. Compared to postscreening, higher scores of psychological distress and sleep disturbance were identified in patients with suspicious TC treated with fine needle aspiration (FNA) or AS. Lower psychological distress and sleep disturbance were noted for benign nodule patients than for TC patients. OP for TC, especially PTMC, did not alleviate psychological distress or sleep disturbance compared with the same parameters in patients who underwent AS.Based on the findings of impaired psychological health and sleep quality, screening for TNs in adults who show no symptoms should be performed with caution. Psychological distress and sleep disturbance should also be taken into consideration when FNA is performed for suspected TC or OP for PTC, especially PTMC.
Ruicen Li, Genpeng Li, Yuting Wang, Ting Bao, Yali Lei, Liuyan Tian, Zhihui Li, Jingqiang Zhu, Jianyong Lei, Huairong Tang