The impact of the built environment on the risk of breast cancer

描述（由申请人提供）： 在美国，乳腺癌（BC）是女性最常见的癌症，其发病率在过去二十年中有所增加。预防这种癌症是困难的，因为大多数确定的因素导致乳腺癌的发生不能轻易改变。肥胖和缺乏身体活动这两个因素是已被证明与BC发生风险较高相关且有可能改变的特征。然而，公共卫生努力，以减少迅速增长的肥胖率和增加体力活动，国家卫生研究院的既定目标，取得了有限的成功。因此，需要新的方向和策略来对抗BC的日益增加。研究现在提供了令人信服的证据，表明身体活动和肥胖与建筑环境，一个人周围环境的人为属性有关，例如人行道的存在和条件，资源的可用性（医疗保健，食品，游乐场，公共交通）以及可步行目的地的数量。然而，以前的研究没有考虑过建筑环境对癌症发病率的影响。结合从加州教师研究收集的调查数据，一个前瞻性队列超过120，000名妇女，与临床乳腺癌信息从加州癌症登记处，和建筑环境特征从地理信息系统（GIS），这将是第一个研究，以测试的假设，即建筑环境影响BC的风险。在此过程中，本研究将1）确定与身体活动和肥胖相关的建筑环境的具体措施; 2）测试这些建筑环境措施是否与BC的风险相关; 3）确定与BC发生相关的其他因素，包括绝经状态和社会经济地位，是否改变这些关联。

DESCRIPTION (provided by applicant): In the United States, the occurrence of breast cancer (BC), the most common cancer in women, has increased for the past two decades. Prevention of this cancer is difficult because most identified factors contributing to breast cancer occurrence cannot easily be modified. Two factors, obesity and physical inactivity, are characteristics that have both been shown to be associated with a higher risk of BC occurrence and to have the potential to be changed. However, public health efforts to reduce the rapidly increasing rates of obesity and increase physical activity, stated goals of the NIH, have yielded limited success. Therefore, new directions and strategies are needed to combat the increasing occurrence of BC. Studies are now providing convincing evidence that physical activity and obesity are associated with the built environment, man-made attributes of a person's surroundings such as the existence and condition of sidewalks, availability of resources (health care, food, playgrounds, public transportation) and the number of walkable destinations. However, no prior studies have considered the influence of the built environment on cancer incidence. Combining survey data collected from the California Teachers Study, a prospective cohort of over 120,000 women, with clinical breast cancer information from the California Cancer Registry, and built environment characteristics from geographic information systems (GIS), this will be the first study to test the hypothesis that the built environment affects the risk of BC. In doing so, this study will 1) determine the specific measures of the built environment that are related to physical activity and obesity; 2) test whether these built environment measures are related to the risk of BC; and 3) determine if other factors related to BC occurrence, including menopausal status and socioeconomic status, change these associations.