Contribution of the neighborhood environment and obesity to breast cancer survival: The California breast cancer survivorship consortium

Iona Cheng, Salma Shariff-Marco, Jocelyn Koo, Kristine R. Monroe, Juan Yang, Esther M. John, Allison W. Kurian, Marilyn L. Kwan, Brian E. Henderson, Leslie Bernstein, Yani Lu, Richard Sposto, Cheryl Vigen, Anna H. Wu, Scarlett Lin Gomez, Theresa H Keegan

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Little is known about neighborhood attributes that may influence opportunities for healthy eating and physical activity in relation to breast cancer mortality. We used data from the California Breast Cancer Survivorship Consortium and the California Neighborhoods Data System (CNDS) to examine the neighborhood environment, body mass index, and mortality after breast cancer.We studied 8,995 African American, Asian American, Latina, and non-Latina white women with breast cancer. Residential addresses were linked to the CNDS to characterize neighborhoods. We used multinomial logistic regression to evaluate the associations between neighborhood factors and obesity and Cox proportional hazards regression to examine associations between neighborhood factors and mortality. For Latinas, obesity was associated with more neighborhood crowding [quartile 4 (Q4) vs. Q1: OR, 3.24; 95% confidence interval (CI), 1.50-7.00]; breast cancer-specific mortality was inversely associated with neighborhood businesses (Q4 vs. Q1: HR, 0.46; 95% CI, 0.25-0.85) and positively associated with multifamily housing (Q3 vs. Q1: HR, 1.98; 95% CI, 1.20-3.26). For non-Latina whites, lower neighborhood socioeconomic status (SES) was associated with obesity [quintile 1 (Q1) vs. Q5: OR, 2.52; 95% CI, 1.31-4.84], breast cancer-specific (Q1 vs. Q5: HR, 2.75; 95% CI, 1.47-5.12), and all-cause (Q1 vs. Q5: HR, 1.75; 95% CI, 1.17-2.62) mortality. For Asian Americans, no associations were seen. For African Americans, lower neighborhood SES was associated with lower mortality in a nonlinear fashion. Attributes of the neighborhood environment were associated with obesity and mortality following breast cancer diagnosis, but these associations differed across racial/ethnic groups.

Original languageEnglish (US)
Pages (from-to)1282-1290
Number of pages9
JournalCancer Epidemiology Biomarkers and Prevention
Issue number8
StatePublished - Aug 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Oncology


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