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Journal of Cancer Survivorship
Published in: Journal of Cancer Survivorship 2/2019

01-04-2019 | Thyroidectomy | Review

Cognitive functioning in thyroid cancer survivors: a systematic review and meta-analysis

Authors: Omar Saeed, Lori J. Bernstein, Rouhi Fazelzad, Mary Samuels, Lynn A. Burmeister, Lehana Thabane, Shereen Ezzat, David P. Goldstein, Jennifer Jones, Anna M. Sawka

Published in: Journal of Cancer Survivorship | Issue 2/2019

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Abstract

Background

Some thyroid cancer (TC) survivors experience cognitive symptoms.

Purpose

The purpose of this study is to perform a systematic literature review and meta-analysis comparing cognitive performance in TC survivors to controls.

Methods

We performed a seven-database electronic search and hand-search. We performed duplicate independent reviews and data abstraction. Random effects meta-analyses reported standardized mean differences (SMDs) with 95% confidence intervals (CIs), where a negative value implies worse performance in the TC group.

Results

We reviewed 1174 unique citations and 10 full-text papers. We included seven studies of 241 treated TC survivors and 273 controls. Cognitive function was statistically significantly worse in TC survivors in the following domains: Attention and Concentration (Digit Span Forwards) SMD − 0.37 (95% CI − 0.62, − 0.13, p = 0.003, four studies), Speed of Processing (Trail Making A) SMD − 0.36 (95% CI − 0.66, − 0.05, p = 0.022, four studies), and Language (Controlled Oral Word Association [COWAT]-Categories) SMD − 0.97 (95% − 1.31, − 0.64, p < 0.001, two studies). Executive Function results varied: COWAT-Letters SMD − 0.60 (95% CI − 0.94, − 0.27, p < 0.001, two studies), Digit Span Backwards SMD − 0.40 (95% CI − 0.64, − 0.15, p = 0.002, four studies), and Trail Making B test SMD − 0.20 (95% CI − 0.51, 0.10, p = 0.191, four studies). Statistical heterogeneity limited the COWAT-Categories and Digit Span Backwards meta-analyses.

Conclusions

Cognitive function was worse in TC survivors in multiple domains. Limitations included few studies, potential confounding, and lack of prospective data.

Implications for Cancer Survivors

TC survivors may experience impairments in cognitive function and should report cognitive concerns to healthcare practitioners.
Appendix
Available only for authorised users
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Metadata
Title
Cognitive functioning in thyroid cancer survivors: a systematic review and meta-analysis
Authors
Omar Saeed
Lori J. Bernstein
Rouhi Fazelzad
Mary Samuels
Lynn A. Burmeister
Lehana Thabane
Shereen Ezzat
David P. Goldstein
Jennifer Jones
Anna M. Sawka
Publication date
01-04-2019
Publisher
Springer US
Published in
Journal of Cancer Survivorship / Issue 2/2019
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-019-00745-1

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