Neighborhood influences on recreational physical activity and survival after breast cancer

Theresa H Keegan, Salma Shariff-Marco, Meera Sangaramoorthy, Jocelyn Koo, Andrew Hertz, Clayton W. Schupp, Juan Yang, Esther M. John, Scarlett L. Gomez

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Purpose: Higher levels of physical activity have been associated with improved survival after breast cancer diagnosis. However, no previous studies have considered the influence of the social and built environment on physical activity and survival among breast cancer patients.

Methods: Our study included 4,345 women diagnosed with breast cancer (1995–2008) from two population-based studies conducted in the San Francisco Bay Area. We examined questionnaire-based moderate/strenuous recreational physical activity during the 3 years before diagnosis. Neighborhood characteristics were based on data from the 2000 US Census, business listings, parks, farmers’ markets, and Department of Transportation. Survival was evaluated using multivariable Cox proportional hazards models, with follow-up through 2009.

Results: Women residing in neighborhoods with no fast-food restaurants (vs. fewer fast-food restaurants) to other restaurants, high traffic density, and a high percentage of foreign-born residents were less likely to meet physical activity recommendations set by the American Cancer Society. Women who were not recreationally physically active had a 22 % higher risk of death from any cause than women that were the most active. Poorer overall survival was associated with lower neighborhood socioeconomic status (SES) (p trend = 0.02), whereas better breast cancer-specific survival was associated with a lack of parks, especially among women in high-SES neighborhoods.

Conclusion: Certain aspects of the neighborhood have independent associations with recreational physical activity among breast cancer patients and their survival. Considering neighborhood factors may aide in the design of more effective, tailored physical activity programs for breast cancer survivors.

Original languageEnglish (US)
Pages (from-to)1295-1308
Number of pages14
JournalCancer Causes and Control
Issue number10
StatePublished - Oct 11 2014
Externally publishedYes


  • Breast cancer
  • Built environment
  • Neighborhood
  • Physical activity
  • Socioeconomic status

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


Dive into the research topics of 'Neighborhood influences on recreational physical activity and survival after breast cancer'. Together they form a unique fingerprint.

Cite this