SAT-348 The patterns and risk factors for post-thyroid cancer depression: Analysis of 511,204 patients from the Korean National Health Insurance Database

Abstract Disclosure: Y. Kang: None. C. Cho: None. S. Moon: None. E. Lee: None. Y. Park: None. S. Lee: None. Background: Survivors of thyroid cancer frequently encounter psychological challenges such as depression, yet predictive factors remain poorly understood. This study aims to identify clinicopathological parameters associated with new-onset depression in thyroid cancer patients undergoing thyroidectomy or active surveillance. Method: A retrospective cohort study was conducted using data from the NHIS-National Health Screening Cohort, covering 511,204 individuals aged 40-79 years diagnosed with thyroid cancer (ICD-10 code C73) from 2002 to 2019. Patients with a history of depression or other cancers were excluded. Parameters analyzed included treatment type (active surveillance, lobectomy, total thyroidectomy), age, sex, income, lifestyle factors, and clinical characteristics. The incidence of depression was assessed based on new diagnoses and antidepressant prescriptions. Results: Among 6,968 thyroid cancer patients, untreated patients had a hazard ratio (HR) of 1.326 (95% CI: 1.057-1.664), lobectomy patients had an HR of 1.299 (95% CI: 1.110-1.521), and total thyroidectomy patients had an HR of 1.197 (95% CI: 1.086-1.320) compared to controls. No significant relationship was found between depression risk and cumulative radioactive iodine dose or levothyroxine dosage. Depression risk was elevated within the first 5 years post-diagnosis but normalized after 5 years. Conclusion: Older adults with thyroid cancer are at a heightened risk of early-onset depression following diagnosis. Clinicians should prioritize psychological support for these patients to enhance postoperative quality of life. Presentation: Saturday, July 12, 2025