Cognitive functioning in thyroid cancer survivors

a systematic review and meta-analysis

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

Research output: Contribution to journalReview article

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.

Original languageEnglish (US)
Pages (from-to)231-243
Number of pages13
JournalJournal of Cancer Survivorship
Volume13
Issue number2
DOIs
StatePublished - Apr 15 2019

Fingerprint

Thyroid Neoplasms
Meta-Analysis
Confidence Intervals
Cognition
Trail Making Test
Neurobehavioral Manifestations
Executive Function
Language
Databases
Delivery of Health Care

Keywords

  • Cancer survivorship
  • Meta-analysis
  • Neurocognitive function
  • Systematic review
  • Thyroid cancer

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)

Cite this

Saeed, O., Bernstein, L. J., Fazelzad, R., Samuels, M., Burmeister, L. A., Thabane, L., ... Sawka, A. M. (2019). Cognitive functioning in thyroid cancer survivors: a systematic review and meta-analysis. Journal of Cancer Survivorship, 13(2), 231-243. https://doi.org/10.1007/s11764-019-00745-1

Cognitive functioning in thyroid cancer survivors : a systematic review and meta-analysis. / Saeed, Omar; Bernstein, Lori J.; Fazelzad, Rouhi; Samuels, Mary; Burmeister, Lynn A.; Thabane, Lehana; Ezzat, Shereen; Goldstein, David P.; Jones, Jennifer; Sawka, Anna M.

In: Journal of Cancer Survivorship, Vol. 13, No. 2, 15.04.2019, p. 231-243.

Research output: Contribution to journalReview article

Saeed, O, Bernstein, LJ, Fazelzad, R, Samuels, M, Burmeister, LA, Thabane, L, Ezzat, S, Goldstein, DP, Jones, J & Sawka, AM 2019, 'Cognitive functioning in thyroid cancer survivors: a systematic review and meta-analysis', Journal of Cancer Survivorship, vol. 13, no. 2, pp. 231-243. https://doi.org/10.1007/s11764-019-00745-1
Saeed, Omar ; Bernstein, Lori J. ; Fazelzad, Rouhi ; Samuels, Mary ; Burmeister, Lynn A. ; Thabane, Lehana ; Ezzat, Shereen ; Goldstein, David P. ; Jones, Jennifer ; Sawka, Anna M. / Cognitive functioning in thyroid cancer survivors : a systematic review and meta-analysis. In: Journal of Cancer Survivorship. 2019 ; Vol. 13, No. 2. pp. 231-243.
@article{bde362fed9834fcab5b67330b6e2d2ea,
title = "Cognitive functioning in thyroid cancer survivors: a systematic review and meta-analysis",
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.",
keywords = "Cancer survivorship, Meta-analysis, Neurocognitive function, Systematic review, Thyroid cancer",
author = "Omar Saeed and Bernstein, {Lori J.} and Rouhi Fazelzad and Mary Samuels and Burmeister, {Lynn A.} and Lehana Thabane and Shereen Ezzat and Goldstein, {David P.} and Jennifer Jones and Sawka, {Anna M.}",
year = "2019",
month = "4",
day = "15",
doi = "10.1007/s11764-019-00745-1",
language = "English (US)",
volume = "13",
pages = "231--243",
journal = "Journal of Cancer Survivorship",
issn = "1932-2259",
publisher = "Springer New York",
number = "2",

}

TY - JOUR

T1 - Cognitive functioning in thyroid cancer survivors

T2 - a systematic review and meta-analysis

AU - Saeed, Omar

AU - Bernstein, Lori J.

AU - Fazelzad, Rouhi

AU - Samuels, Mary

AU - Burmeister, Lynn A.

AU - Thabane, Lehana

AU - Ezzat, Shereen

AU - Goldstein, David P.

AU - Jones, Jennifer

AU - Sawka, Anna M.

PY - 2019/4/15

Y1 - 2019/4/15

N2 - 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.

AB - 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.

KW - Cancer survivorship

KW - Meta-analysis

KW - Neurocognitive function

KW - Systematic review

KW - Thyroid cancer

UR - http://www.scopus.com/inward/record.url?scp=85064925048&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064925048&partnerID=8YFLogxK

U2 - 10.1007/s11764-019-00745-1

DO - 10.1007/s11764-019-00745-1

M3 - Review article

VL - 13

SP - 231

EP - 243

JO - Journal of Cancer Survivorship

JF - Journal of Cancer Survivorship

SN - 1932-2259

IS - 2

ER -