The association between neighborhood obesogenic factors and prostate cancer risk and mortality: the Southern Community Cohort Study

Fekede Asefa Kumsa; Jay H Fowke; Soheil Hashtarkhani; Brianna M White; Martha J Shrubsole; Arash Shaban-Nejad

doi:10.3389/fonc.2024.1343070

The association between neighborhood obesogenic factors and prostate cancer risk and mortality: the Southern Community Cohort Study

Front Oncol. 2024 Apr 9:14:1343070. doi: 10.3389/fonc.2024.1343070. eCollection 2024.

Authors

Fekede Asefa Kumsa¹, Jay H Fowke², Soheil Hashtarkhani¹, Brianna M White¹, Martha J Shrubsole³, Arash Shaban-Nejad¹

Affiliations

¹ Department of Pediatrics, College of Medicine, The University of Tennessee Health Science Center (UTHSC) - Oak Ridge National Laboratory (ORNL) Center for Biomedical Informatics, Memphis, TN, United States.
² Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States.
³ Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, United States.

Abstract

Background: Prostate cancer is one of the leading causes of cancer-related mortality among men in the United States. We examined the role of neighborhood obesogenic attributes on prostate cancer risk and mortality in the Southern Community Cohort Study (SCCS).

Methods: From the total of 34,166 SCCS male participants, 28,356 were included in the analysis. We assessed the relationship between neighborhood obesogenic factors [neighborhood socioeconomic status (nSES) and neighborhood obesogenic environment indices including the restaurant environment index, the retail food environment index, parks, recreational facilities, and businesses] and prostate cancer risk and mortality by controlling for individual-level factors using a multivariable Cox proportional hazards model. We further stratified prostate cancer risk analysis by race and body mass index (BMI).

Results: Median follow-up time was 133 months [interquartile range (IQR): 103, 152], and the mean age was 51.62 (SD: ± 8.42) years. There were 1,524 (5.37%) prostate cancer diagnoses and 98 (6.43%) prostate cancer deaths during follow-up. Compared to participants residing in the wealthiest quintile, those residing in the poorest quintile had a higher risk of prostate cancer (aHR = 1.32, 95% CI 1.12-1.57, p = 0.001), particularly among non-obese men with a BMI < 30 (aHR = 1.46, 95% CI 1.07-1.98, p = 0.016). The restaurant environment index was associated with a higher prostate cancer risk in overweight (BMI ≥ 25) White men (aHR = 3.37, 95% CI 1.04-10.94, p = 0.043, quintile 1 vs. None). Obese Black individuals without any neighborhood recreational facilities had a 42% higher risk (aHR = 1.42, 95% CI 1.04-1.94, p = 0.026) compared to those with any access. Compared to residents in the wealthiest quintile and most walkable area, those residing within the poorest quintile (aHR = 3.43, 95% CI 1.54-7.64, p = 0.003) or the least walkable area (aHR = 3.45, 95% CI 1.22-9.78, p = 0.020) had a higher risk of prostate cancer death.

Conclusion: Living in a lower-nSES area was associated with a higher prostate cancer risk, particularly among Black men. Restaurant and retail food environment indices were also associated with a higher prostate cancer risk, with stronger associations within overweight White individuals. Finally, residing in a low-SES neighborhood or the least walkable areas were associated with a higher risk of prostate cancer mortality.

Keywords: built environments; mortality; neighborhood obesogenic factors; neighborhood socioeconomic environments; prostate cancer; the Southern Community Cohort Study.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study is partially supported by Grant# 1R37CA234119-01A1 from the National Cancer Institute (NCI). Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number U01CA202979. SCCS data collection was performed by the Survey and Biospecimen Shared Resource, which is supported in part by the Vanderbilt-Ingram Cancer Center (P30 CA68485).