BACKGROUND Living in neighborhoods with higher levels of walkability has been associated with a reduced risk of obesity and higher levels of physical activity. Obesity has been linked to increased risk of 13 cancers in women. However, long-term prospective studies of neighborhood walkability and risk for obesity-related cancer are scarce. OBJECTIVES We evaluated the association between long-term average neighborhood walkability and obesity-related cancer risk in women. METHODS The New York University Women's Health Study (NYUWHS) is a prospective cohort with 14,274 women recruited between 1985 and 1991 in New York City and followed over nearly three decades. We geocoded residential addresses for each participant throughout follow-up and calculated an average annual measure of neighborhood walkability across years of follow-up using data on population density and accessibility to destinations associated with geocoded residential addresses. We used ICD-9 codes to characterize first primary obesity-related cancers and employed Cox proportional hazards models to assess the association between average neighborhood walkability and risk of overall and site-specific obesity-related cancers. RESULTS Residing in neighborhoods with a higher walkability level was associated with a reduced risk of overall and site-specific obesity-related cancers. The hazards ratios associated with a 1-standard deviation increase in average annual neighborhood walkability were 0.88 (95% CI: 0.85, 0.93) for overall obesity-related cancer, 0.89 (95% CI: 0.84, 0.95) for postmenopausal breast cancer, 0.82 (95% CI: 0.68, 0.99) for ovarian cancer, 0.87 (95% CI: 0.76, 0.99) for endometrial cancer, and 0.68 (95% CI: 0.49, 0.94) for multiple myeloma, adjusting for potential confounders at both the individual and neighborhood level. The association between neighborhood walkability and risk of overall obesity-related cancer was stronger among women living in neighborhoods with higher levels of poverty compared with women living in areas with lower poverty levels (pInteraction=0.006). DISCUSSION Our study highlights a potential protective role of neighborhood walkability in preventing obesity-related cancers in women. https://doi.org/10.1289/EHP11538.

中文翻译：

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纽约大学女性健康研究 (NYUWHS) 中的长期暴露于适合步行的住宅区和肥胖相关癌症的风险。

背景技术居住在步行适宜性较高的社区与肥胖风险降低和身体活动水平较高相关。肥胖与女性患 13 种癌症的风险增加有关。然而，关于社区步行能力和肥胖相关癌症风险的长期前瞻性研究却很少。目标 我们评估了女性长期平均社区步行能力与肥胖相关癌症风险之间的关联。方法 纽约大学女性健康研究 (NYUWHS) 是一项前瞻性队列研究，1985 年至 1991 年间在纽约市招募了 14,274 名女性，并对其进行了近三十年的跟踪调查。我们在整个随访过程中对每个参与者的住宅地址进行了地理编码，并使用与地理编码住宅地址相关的人口密度和目的地可达性数据，计算了多年随访中社区步行适宜性的平均年度测量值。我们使用 ICD-9 代码来表征第一个原发性肥胖相关癌症，并采用 Cox 比例风险模型来评估平均社区步行能力与整体和特定部位肥胖相关癌症风险之间的关联。结果居住在步行适宜性较高的社区与整体和特定部位肥胖相关癌症的风险降低相关。与平均年邻里步行能力增加 1 个标准差相关的风险比，总体肥胖相关癌症为 0.88 (95% CI: 0.85, 0.93)，绝经后乳腺癌为 0.89 (95% CI: 0.84, 0.95)，绝经后乳腺癌为 0.82 (95% CI: 0.68, 0.99) 卵巢癌，0.87 (95% CI: 0.76, 0.99) 子宫内膜癌，0.68 (95% CI: 0.49, 0.94) 多发性骨髓瘤，调整了两个个体的潜在混杂因素和邻里层面。与居住在贫困水平较低地区的女性相比，居住在贫困水平较高社区的女性中，社区步行能力与总体肥胖相关癌症风险之间的关联性更强（pInteraction=0.006）。讨论我们的研究强调了社区步行能力在预防女性肥胖相关癌症方面的潜在保护作用。https://doi.org/10.1289/EHP11538。