Wording used may affect thyroid cancer patients' anxiety, choices

(HealthDay)—The terminology used to describe small papillary thyroid cancers (PTCs) may affect patients' anxiety levels and treatment choices, according to a study published online Aug. 23 in JAMA Otolaryngology-Head & Neck Surgery.

Brooke Nickel, M.P.H., from the University of Sydney, and colleagues performed a randomized crossover study of 550 Australian adults without a history of thyroid cancer. The participants accessed an online study that presented three hypothetical but clinically realistic scenarios that described PTC as papillary thyroid cancer, papillary lesion, or abnormal cells. They were exposed to all three scenarios and were randomized by the order in which they viewed them.

The researchers found that a higher proportion of participants (19.6 percent) chose total thyroidectomy when papillary thyroid cancer was used to describe the condition versus 10.5 percent of when papillary lesion was used and 10.9 percent when abnormal cells was used. One-third (32.3 percent) of those who viewed papillary thyroid cancer terminology first chose surgery compared with 24.1 percent who were exposed to papillary lesion terminology (risk ratio, 0.73; 95 percent confidence interval, 0.53 to 1.02) and 27.2 percent who were exposed to abnormal cells (risk ratio, 0.82; 95 percent confidence interval, 0.6 to 1.14). Participants who viewed papillary thyroid cancer terminology at first exposure reported significantly higher levels of anxiety (mean, 7.8 of 11 points) versus those who viewed the papillary lesion (mean, 7 of 11 points; mean difference −0.8; 95 percent confidence interval, −1.3 to −0.3) or abnormal cells (mean, 7.3 of 11 points; mean difference, −0.5; 95 percent confidence interval, −1 to 0.01) terminology.

"Changing the terminology of small PTCs may be one strategy to reduce patients' anxiety levels and help them consider less invasive management options," the authors write.

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