Case study

Sleep quality, anxiety and depression
in patients with thyroid cancer in China


The 21st Century has seen a growing trend in the prevalence of thyroid cancer. In the majority of cases, differentiated thyroid cancer can be successfully treated by thyroidectomy, radioactive iodine treatment and thyrotropin suppression therapy (with a 5-year survival rate greater than 97%). However, the surgery and the first course of radioactive iodine treatment are mentally and physically challenging to patients. Patients have been reported with anxiety, depression and sleep issues during their treatment pathways, which can cause lifetime consequences. Psychological fear of cancer, nuclear medicine therapy and metastasis are major driving factors. In China, social stigma related to religious and cultural beliefs of upholding social harmony and maintaining personal reputation contribute to a reticence in seeking mental health treatment. In addition, Chinese patients with life-threatening diseases (such as thyroid cancer) are in favour of attending large hospital to get treatment. This adds an extra burden to patients from low income families. It also leads to significant imbalance in the current health care system.

In China, 182,110 new thyroid cancer cases are diagnosed each year.


Lead researchers


Project funded by


Project partners

Prof. Colin Martin, Faculty of Health Sciences, University of Hull, UK

Prof. Zhaowei Meng, Tianjin Medical University General Hospital, China

A prospective cohort study is currently being conducted in one nuclear ward and one surgical ward of a large district general hospital in Tianjin, China. We aim to investigate the sleeping quality, anxiety and depression in patients with thyroid cancer during their treatment pathway - pre, during and post thyroid cancer treatment. Study outcomes will be summarised at each time point and compared to those from control group. 

The research is being led by Dr. Chao Huang, Senior Lecturer in Statistics and Methods Hub, Hull York Medical School.

The Impact

Our ultimate aim is to add mental health assistance to the current thyroid cancer treatment, which can lead to better treatment outcomes and help patients to be both physically and mentally ready to return to normal work and life. The output of this research will raise the awareness of mental health issues in Chinese thyroid cancer patients and trigger the development of early interventions in patient mental health.


Upon successful completion of this prospective cohort study, we will develop a low-cost mental health treatment package. This package will be embedded into the current surgical and radioactive treatment, in order to shorten the treatment process and lead to a better patient experience. Also it can reduce the economic burden in current health system and improve the social relationships between patients and health professionals in China.