Factors Associated with Anxiety and Depression After Thyroid Cancer Diagnosis

Tuesday, October 14, 2025

9:48 AM - 9:54 AM EDT

Location: 128

Disclosure(s):

Matthew E. Lin, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Thyroid cancer is known to be associated with anxiety and depression, but those most at risk for anxiety and depression is unknown. This study seeks to examine demographic and medical risk factors for anxiety and depression among thyroid cancer survivors.

Methods: Using the TriNetX US Collaborative Network, we assessed the 5-year risk of new anxiety and/or depression diagnosis after thyroid cancer diagnosis among adults (≥18 years) with cancer staging information and no prior anxiety/depression diagnosis. Potential risk factors analyzed included AJCC clinical summary stage, surgical treatment, radioactive iodine ablation, sex, race, ethnicity, and primary language. The relative risk of a new anxiety/depressive disorder diagnosis was calculated after performing 1:1 propensity score matching between comparison cohorts for the risk factors for anxiety/depression above as well as age, primary language, alcohol use disorder, tobacco use, stroke, heart failure, Type 2 diabetes, and obesity.

Results: Thyroid cancer patients were more likely to be diagnosed with anxiety and/or depression within five years of diagnosis (RR: 1.70 [95%CI: 1.54-2.02]). Stage 4 disease was associated with higher risk than Stage 1 disease (RR: 1.85 [95%CI: 1.33-2.58]). Females had a higher risk of anxiety/depression than males (RR: 1.23 [95%CI: 1.01-1.50]). Non-white individuals had lower risk of new anxiety and/or depression diagnosis (RR: 0.70 [95%CI: 0.55-0.89]), while Hispanic ethnicity (compared to non-Hispanic ethnicity) was linked to increased risk (RR: 2.00 [95%CI: 1.27-3.16]). A diagnosis of anxiety/depression was also associated with more emergency department visits within 30 days of thyroid cancer diagnosis (RR: 2.60 [95%CI: 1.45-4.68]), but no change in 5-year overall survival (RR: 1.20 [95%CI: 0.80-1.79]).

Conclusions: Stage 4 disease, female sex, White race, and Hispanic ethnicity are associated with development of a new anxiety/depression diagnosis after thyroid cancer diagnosis. Future research should focus on developing prognostic tools to further risk stratify patients and improve mental health support.

Presenting Author(s)

Matthew E. Lin, MD

Resident Physician
Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA
Los Angeles, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Tyler J. Gallagher, MD MPH

Resident Physician
Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California
Monterey Park, CA, United States

Disclosure information not submitted.

Co-Author(s)

Josef Madrigal, MD

Resident
University of California, Los Angeles
LOS ANGELES, CA, United States

Disclosure information not submitted.
EW

Eric X. Wei, MD

Resident Physician
Department of Otolaryngology-Head and Neck Surgery, Stanford School of Medicine
Stanford, CA, United States

Disclosure information not submitted.

Senior Author(s)

MC

Michelle M. Chen, MD, MHS

Assistant Professor
Stanford University
Palo Alto, CA, United States

Disclosure information not submitted.