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Association of Living in Urban Food Deserts with Mortality from Breast and Colorectal Cancer

  • Health Services Research and Global Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Food deserts are neighborhoods with low access to healthy foods and are associated with poor health metrics. We investigated association of food desert residence and cancer outcomes.

Methods

In this population-based study, data from the 2000–2012 California Cancer Registry was used to identify patients with stage II/III breast or colorectal cancer. Patient residence at time of diagnosis was linked by census tract to food desert using the USDA Food Access Research Atlas. Treatment and outcomes were compared by food desert residential status.

Results

Among 64,987 female breast cancer patients identified, 66.8% were < 65 years old, and 5.7% resided in food deserts. Five-year survival for food desert residents was 78% compared with 80% for non-desert residents (p < 0.0001). Among 48,666 colorectal cancer patients identified, 50.4% were female, 39% were > 65 years old, and 6.4% resided in food deserts. Five-year survival for food desert residents was 60% compared with 64% for non-desert residents (p < 0.001). Living in food deserts was significantly associated with diabetes, tobacco use, poor insurance coverage, and low socioeconomic status (p < 0.05) for both cancers. There was no significant difference in rates of surgery or chemotherapy by food desert residential status for either diagnosis. Multivariable analyses showed that food desert residence was associated with higher mortality.

Conclusion

Survival, despite treatment for stage II/III breast and colorectal cancers was worse for those living in food deserts. This association remained significant without differences in use of surgery or chemotherapy, suggesting factors other than differential care access may link food desert residence and cancer outcomes.

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Acknowledgment

Yuman Fong, MD had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The authors would like to thank Supriya Deshpande, PhD for assistance with manuscript editing.

Funding

Supported by grant P30 CA033572 from the NIH.

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Authors and Affiliations

  1. Department of Surgery, Cedar-Sinai Hospital, Los Angeles, CA, USA

    Abigail J. Fong MD

  2. Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA

    Abigail J. Fong MD, Kelly Lafaro MD, Philip H. G. Ituarte PhD & Yuman Fong MD

  3. Department of Surgery, Johns Hopkins University, Baltimore, MD, USA

    Kelly Lafaro MD

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  1. Abigail J. Fong MD
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  2. Kelly Lafaro MD
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Correspondence to Yuman Fong MD.

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Fong, A.J., Lafaro, K., Ituarte, P.H.G. et al. Association of Living in Urban Food Deserts with Mortality from Breast and Colorectal Cancer. Ann Surg Oncol 28, 1311–1319 (2021). https://doi.org/10.1245/s10434-020-09049-6

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  • DOI: https://doi.org/10.1245/s10434-020-09049-6

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