. 2023 Oct 4;131(10):107001. doi: 10.1289/EHP11538

Table 2.

Obesity-related cancer HRs and 95% CIs based on neighborhood walkability (NW) in the NYUWHS, years 1985–2016 ( $lowercase italic n equal 13,240$ ).

Cancer subtype	NW Q1 [ $negative 0.8$ , 0.9 (Ref)]	NW Q2 [0.9, 3.3 HR (95% CI)]	NW Q3 [3.3, 8.1 HR (95% CI)]	NW Q4 [8.1, 44.6 HR (95% CI)]	Per SD (continuous NW) HR (95% CI)^a
Overall (any first incident obesity-related cancer)
Cases ( $n$ )	614	603	619	575	2,411
Model 1^b	Ref	0.94 (0.84, 1.05)	0.93 (0.83, 1.04)	0.76 (0.68, 0.86)	0.90 (0.86, 0.94)
Model 2^c	Ref	0.94 (0.84, 1.05)	0.92 (0.81, 1.03)	0.74 (0.65, 0.85)	0.89 (0.85, 0.93)
Model 3^d	Ref	0.94 (0.84, 1.05)	0.92 (0.82, 1.04)	0.77 (0.68, 0.88)	0.90 (0.86, 0.94)
Postmenopausal breast cancer^e
Cases ( $n$ )	336	311	311	311	1,269
Model 1^b	Ref	0.88 (0.76, 1.03)	0.84 (0.72, 0.99)	0.73 (0.62, 0.86)	0.89 (0.84, 0.95)
Model 2^c	Ref	0.89 (0.76, 1.05)	0.86 (0.72, 1.01)	0.73 (0.61, 0.87)	0.89 (0.84, 0.95)
Model 3^d	Ref	0.89 (0.76, 1.05)	0.86 (0.73, 1.02)	0.75 (0.63, 0.89)	0.90 (0.85, 0.96)
Colorectal cancer
Cases ( $n$ )	88	83	90	82	343
Model 1^b	Ref	0.88 (0.65, 1.19)	0.93 (0.69, 1.25)	0.82 (0.60, 1.13)	0.92 (0.82, 1.04)
Model 2^c	Ref	0.87 (0.64, 1.18)	0.91 (0.66, 1.25)	0.79 (0.56, 1.11)	0.91 (0.80, 1.03)
Model 3^d	Ref	0.87 (0.64, 1.19)	0.92 (0.67, 1.27)	0.83 (0.57, 1.17)	0.92 (0.82, 1.05)
Colon cancer
Cases ( $n$ )	69	63	79	64	275
Model 1^b	Ref	0.85 (0.60, 1.19)	1.04 (0.74, 1.44)	0.82 (0.58, 1.17)	0.94 (0.83, 1.07)
Model 2^c	Ref	0.84 (0.59, 1.19)	1.01 (0.71, 1.43)	0.80 (0.54, 1.17)	0.92 (0.80, 1.06)
Model 3^d	Ref	0.84 (0.59, 1.19)	1.03 (0.72, 1.46)	0.83 (0.57, 1.23)	0.94 (0.82, 1.08)
Rectal cancer
Cases ( $n$ )	19	20	11	18	68
Model 1^b	Ref	0.98 (0.52, 1.86)	0.52 (0.25, 1.11)	0.82 (0.42, 1.60)	0.87 (0.67, 1.14)
Model 2^c	Ref	1.00 (0.53, 1.90)	0.52 (0.23, 1.15)	0.77 (0.36, 1.61)	0.86 (0.65, 1.14)
Model 3^d	Ref	1.00 (0.53, 1.91)	0.53 (0.24, 1.17)	0.80 (0.38, 1.68)	0.86 (0.65, 1.15)
Cancer of the uterus and endometrium
Cases ( $n$ )	71	68	75	68	282
Model 1^b	Ref	0.96 (0.69, 1.34)	1.00 (0.72, 1.39)	0.80 (0.56, 1.13)	0.91 (0.80, 1.03)
Model 2^c	Ref	0.93 (0.66, 1.31)	0.93 (0.66, 1.33)	0.71 (0.49, 1.04)	0.87 (0.76, 0.99)
Model 3^d	Ref	0.93 (0.66, 1.30)	0.94 (0.66, 1.34)	0.77 (0.52, 1.12)	0.90 (0.79, 1.03)
Ovarian cancer
Cases ( $n$ )	29	34	43	32	138
Model 1^b	Ref	1.19 (0.72, 1.95)	1.43 (0.89, 2.31)	0.85 (0.51, 1.43)	0.85 (0.71, 1.02)
Model 2^c	Ref	1.20 (0.72, 1.98)	1.48 (0.89, 2.46)	0.84 (0.48, 1.47)	0.82 (0.68, 0.99)
Model 3^d	Ref	1.21 (0.73, 2.00)	1.50 (0.90, 2.49)	0.85 (0.48, 1.51)	0.83 (0.68, 1.00)
Pancreatic cancer
Cases ( $n$ )	28	29	27	24	108
Model 1^b	Ref	1.02 (0.60, 1.72)	0.95 (0.56, 1.64)	0.85 (0.48, 1.50)	0.92 (0.75, 1.13)
Model 2^c	Ref	0.97 (0.57, 1.64)	0.83 (0.47, 1.48)	0.70 (0.38, 1.30)	0.86 (0.69, 1.08)
Model 3^d	Ref	0.97 (0.57, 1.65)	0.86 (0.48, 1.52)	0.75 (0.40, 1.40)	0.88 (0.70, 1.11)
Multiple myeloma and malignant plasma cell neoplasms
Cases ( $n$ )	17	26	20	10	73
Model 1^b	Ref	1.41 (0.76, 2.62)	1.06 (0.55, 2.06)	0.55 (0.25, 1.24)	0.77 (0.58, 1.03)
Model 2^c	Ref	1.25 (0.67, 2.33)	0.77 (0.38, 1.55)	0.38 (0.16, 0.91)	0.68 (0.49, 0.94)
Model 3^d	Ref	1.26 (0.67, 2.34)	0.76 (0.38, 1.54)	0.40 (0.17, 0.94)	0.69 (0.50, 0.96)
Renal cancer
Cases ( $n$ )	18	26	16	13	73
Model 1^b	Ref	1.29 (0.70, 2.38)	0.73 (0.37, 1.46)	0.57 (0.27, 1.19)	0.80 (0.61, 1.05)
Model 2^c	Ref	1.28 (0.69, 2.37)	0.74 (0.36, 1.54)	0.61 (0.27, 1.36)	0.83 (0.62, 1.11)
Model 3^d	Ref	1.28 (0.69, 2.36)	0.74 (0.35, 1.53)	0.63 (0.28, 1.40)	0.85 (0.63, 1.14)
Thyroid cancer
Cases ( $n$ )	16	15	17	22	70
Model 1^b	Ref	0.95 (0.47, 1.93)	0.99 (0.50, 1.98)	0.98 (0.50, 1.92)	0.93 (0.73, 1.17)
Model 2^c	Ref	1.07 (0.52, 2.19)	1.30 (0.62, 2.71)	1.43 (0.69, 2.97)	1.03 (0.80, 1.31)
Model 3^d	Ref	1.07 (0.52, 2.18)	1.26 (0.60, 2.64)	1.35 (0.64, 2.81)	1.00 (0.78, 1.29)

Note: Cox proportional hazard (PH) models were implemented for neighborhood walkability as predictor of first incident obesity-related cancer adjusted for covariates. Missing observations for covariates alcohol (15.7%), smoking status (9.4%), education level (18.1%), and race/ethnicity (12.3%) were included in the models using multiple imputation with 10 iterations. Only cancer subtypes with a number of first obesity-related malignant cancer cases $lowercase italic n greater than 30$ are shown in the table. A total of 316,783.5 person-years at risk were accrued throughout the study. BMI, body mass index; CI, confidence interval; HR, hazard ratio; NYUWHS, New York University Women’s Health Study; Q, quartile; Ref, reference; SD, standard deviation.

^{^a}

Continuous neighborhood walkability variable scaled to the SD ( $standard deviation equals 5.9$ ).

^{^b}

Adjusting for baseline age, race/ethnicity, education level, smoking status, and ever moving residence at any time during the study follow-up.

^{^c}

Adjusting for covariates in model 1 and additionally for alcohol intake, menopausal status, parity, and percentage below the poverty level living in neighborhood.

^{^d}

Adjusting for model 2 covariates and additionally for potential mediators outdoor walking, baseline BMI, and BMI change (the difference between the second to last reported BMI before incident obesity-related cancer or end of follow-up and BMI at enrollment). Missing observations for outdoor walking (20.2%) were included in the models using multiple imputation with 10 iterations.

^{^e}

Breast cancer diagnosed after menopause. Twenty-one women had unknown menopausal status at breast cancer diagnosis that were treated as a postmenopausal diagnosis if age at diagnosis was $greater than 50$ and treated as premenopausal if age at diagnosis was $less than 50$ years of age.