Association Between Pre-existing Schizophrenia and Lung Cancer Outcomes: A TriNetX Analysis

Area of Science:

• Oncology
• Psychiatry
• Public Health

Background:

• Patients with schizophrenia spectrum disorders (SSD) have reduced life expectancy.
• Cancer incidence is similar, but lung cancer mortality in SSD patients is understudied.
• This study investigates lung cancer mortality in patients with and without SSD.

Purpose of the Study:

• To compare all-cause lung cancer mortality rates between patients with and without SSD.
• To identify survival differences in lung cancer patients with SSD.
• To analyze survival outcomes based on lung cancer stage.

Main Methods:

• Utilized the TriNetX Network to identify patients with primary lung cancer.
• Constructed two cohorts: one with SSD and one without, preceding lung cancer diagnosis.
• Used propensity matching (1:1) and Kaplan-Meier survival analysis for 1, 3, and 5-year outcomes.

Main Results:

• After matching, 511 patients were in each cohort (SSD vs. no-SSD).
• SSD patients showed significantly higher lung cancer mortality at 1, 3, and 5 years (HRs ranging from 0.760 to 0.790).
• Stage 3 lung cancer survival was notably worse in SSD patients at 3 and 5 years; median survival was 641 days (SSD) vs. 1132 days (no-SSD).

Conclusions:

• Lung cancer outcomes are worse for patients with SSD.
• Observed outcome differences correlate with variations in treatment choices, especially in stage 3.
• Further research is needed on treatment modalities, adherence, and causes of death in SSD patients with lung cancer.