title: A Cohort Study of Mortality in Individuals With and Without Schizophrenia After Diagnosis of Lung Cancer.
abstract: OBJECTIVE
  Individuals with serious mental illness have increased mortality relative to those without these illnesses. Although cancer is a leading cause of death, few studies have evaluated potential disparities relative to mortality for individuals with serious mental illness who are diagnosed with cancer. In this study, we evaluated mortality after diagnosis of a common malignancy (lung cancer) in a prototypical serious mental illness (schizophrenia).
  
  
  METHODS
  Using administrative data in the Veterans Affairs system, we identified 34,664 individuals who were diagnosed with lung cancer between October 1, 2001, and September 30, 2005. We conducted a survival analysis comparing individuals with and without ICD-9-CM schizophrenia using data through September 30, 2010. Controlling variables were age, gender, smoking status, marital status, service connection, homelessness status, and presence of a substance use disorder.
  
  
  RESULTS
  Our results demonstrated significantly poorer survival after lung cancer diagnosis for individuals with schizophrenia compared to those without schizophrenia. The hazard ratio for all-cause mortality associated with schizophrenia was 1.33 (95% CI, 1.22-1.44).
  
  
  CONCLUSIONS
  Individuals with schizophrenia are at higher risk of death after diagnosis of lung cancer than those without schizophrenia. Future studies should further characterize cause of death, quality of cancer care received, and barriers to care.
authors: Durham VA Medical Center, 1830 Hillandale Rd, Durham, NC 27705. Daniel.bradford@duke.edu.|Durham VA Medical Center, Durham, North Carolina, USA.|Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.
authors: Daniel W
authors: DW
authors: Bradford
authors: Pain, Research, Informatics, Multi-morbidities, and Education Center (PRIME), VA Connecticut Healthcare System, West Haven, Connecticut, USA.|Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
authors: Joseph
authors: J
authors: Goulet
authors: Mental Illness Research, Education, and Clinical Center, Veterans Health Administration, West Haven, Connecticut, USA.|Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
authors: Marcia
authors: M
authors: Hunt
authors: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.
authors: Natasha C
authors: NC
authors: Cunningham
authors: Mental Illness Research, Education, and Clinical Center, Veterans Health Administration, West Haven, Connecticut, USA.|Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
authors: Rani
authors: R
authors: Hoff
mesh_terms: D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000453:epidemiology / Q000401:mortality*; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data*