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Contextual Impact of Neighborhood Obesogenic Factors on Postmenopausal Breast Cancer: The Multiethnic Cohort.
- Source :
-
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology [Cancer Epidemiol Biomarkers Prev] 2017 Apr; Vol. 26 (4), pp. 480-489. Date of Electronic Publication: 2017 Jan 31. - Publication Year :
- 2017
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Abstract
- Background: While obesity is well-understood to increase breast cancer risk, the role of the neighborhood obesogenic environment, encompassing social and built environment attributes that influence body size, is poorly understood. Methods: Using principal components factor analysis, five composite factors [neighborhood socioeconomic status (nSES), urban, mixed-land development, unhealthy food environment, parks] on the basis of geospatial data were developed to characterize the obesogenic environment for 48,247 postmenopausal women in the Multiethnic Cohort, residing predominately in Los Angeles County. We used Cox proportional hazards regression to examine the association between neighborhood obesogenic factors and breast cancer risk ( n = 2,341 cases after 17 years of follow-up), adjusting for body mass index (BMI), weight gain since age 21, education, established risk factors, other neighborhood factors, and clustering by block group. Results: Lower nSES was associated with lower breast cancer risk [quintile 1 vs. 5: HR, 0.79; 95% confidence interval (CI), 0.66-0.95], with a more pronounced association observed in Latinos (quintile 1 vs. 5: HR, 0.60; 95% CI, 0.43-0.85). More urban environments were associated with lower breast cancer risk in Japanese Americans (quintile 5 vs. 1: HR, 0.49; 95% CI, 0.26-0.90), and lower mixed-land development was associated with higher breast cancer risk in Latinos (quintile 1 vs. 5: HR, 1.46; 95% CI, 1.10-1.93). Conclusions: Obesogenic neighborhood environment factors, especially nSES, urbanicity, and mixed-land development, were differentially and independently associated with breast cancer risk in this multiethnic population. Impact: These findings highlight the need for additional studies of the driving contextual aspects of nSES that influence breast cancer risk. Cancer Epidemiol Biomarkers Prev; 26(4); 480-9. ©2017 AACR See all the articles in this CEBP Focus section, "Geospatial Approaches to Cancer Control and Population Sciences."<br /> (©2017 American Association for Cancer Research.)
- Subjects :
- Black or African American statistics & numerical data
Aged
Asian statistics & numerical data
Breast Neoplasms epidemiology
Breast Neoplasms ethnology
California epidemiology
Factor Analysis, Statistical
Female
Hispanic or Latino statistics & numerical data
Humans
Middle Aged
Obesity epidemiology
Obesity ethnology
Postmenopause
Principal Component Analysis
Proportional Hazards Models
Prospective Studies
Risk Factors
Self Report
White People statistics & numerical data
Body Mass Index
Breast Neoplasms etiology
Obesity etiology
Residence Characteristics
Weight Gain
Subjects
Details
- Language :
- English
- ISSN :
- 1538-7755
- Volume :
- 26
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
- Publication Type :
- Editorial & Opinion
- Accession number :
- 28143808
- Full Text :
- https://doi.org/10.1158/1055-9965.EPI-16-0941