Table 1.
Associations between colorectal cancer risk and body mass index and the neighborhood obesogenic environment in males, Multiethnic Cohort, 1993 – 2010
| Males | Overall N=35,397 |
African Americans N=9,190 |
Japanese Americans N=5,222 |
Latinos N=16,724 |
Whites N=4,261 |
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No. | HRa | 95% CI | p-intb | No. | HRc | 95% CI | No. | HRc | 95% CI | No. | HRc | 95% CI | No. | HRc | 95% CI | |
| Body mass index (kg/m2) | ||||||||||||||||
| <18.5 | 8 | 1.73 | (0.86–3.49) | 5 | 3.25d | (1.24–8.54) | 2 | 1.14 | (0.28–4.66) | 1 | 0.88 | (0.13–6.04) | 0 | |||
| 18.5–24.9 | 315 | 1.00 | 76 | 1.00 | 102 | 1.00 | 108 | 1.00 | 29 | 1.00 | ||||||
| 25.0–29.9 | 472 | 1.01 | (0.87–1.17) | 124 | 0.95 | (0.71–1.27) | 72 | 0.97 | (0.70–1.34) | 218 | 0.94 | (0.74–1.19) | 58 | 1.57 | (0.98–2.51) | |
| ≥30.0 | 186 | 1.18 | (0.98–1.43) | 80 | 1.42e | (1.03–1.96) | 11 | 1.21 | (0.65–2.26) | 80 | 0.97 | (0.73–1.31) | 15 | 1.21 | (0.62–2.37) | |
|
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| Neighborhood socioeconomic statuse | 0.52 | |||||||||||||||
| Q5 high | 126 | 1.00 | 20 | 1.00 | 43 | 1.00 | 36 | 1.00 | 27 | 1.00 | ||||||
| Q4 | 209 | 1.21 | (0.96–1.53) | 53 | 1.45 | (0.84–2.51) | 62 | 1.19 | (0.75–1.88) | 66 | 1.17 | (0.79–1.75) | 28 | 1.14 | (0.63–2.07) | |
| Q3 | 219 | 1.21 | (0.95–1.56) | 47 | 1.11 | (0.62–1.96) | 42 | 1.09 | (0.68–1.76) | 108 | 1.42 | (0.95–2.12) | 22 | 0.96 | (0.50–1.85) | |
| Q2 | 230 | 1.09 | (0.83–1.44) | 79 | 1.12 | (0.62–2.03) | 28 | 1.42 | (0.78–2.59) | 109 | 1.12 | (0.73–1.74) | 14 | 0.83 | (0.35–1.98) | |
| Q1 low | 196 | 1.06 | (0.77–1.45) | 86 | 1.07 | (0.56–2.02) | 12 | 1.36 | (0.57–3.26) | 87 | 1.07 | (0.64–1.78) | 11 | 1.33 | (0.48–3.72) | |
| p-trendf | 0.95 | 0.52 | 0.38 | 0.94 | 0.95 | |||||||||||
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| Population densitye | 0.67 | |||||||||||||||
| Q5 high | 171 | 1.00 | 62 | 1.00 | 23 | 1.00 | 73 | 1.00 | 13 | 1.00 | ||||||
| Q4 | 225 | 1.02 | (0.82–1.28) | 82 | 0.89 | (0.62–1.28) | 29 | 0.80 | (0.40–1.58) | 95 | 1.17 | (0.82–1.68) | 19 | 1.20 | (0.56–2.56) | |
| Q3 | 229 | 0.99 | (0.78–1.27) | 61 | 0.81 | (0.53–1.22) | 50 | 0.85 | (0.42–1.73) | 96 | 1.10 | (0.74–1.62) | 22 | 1.04 | (0.44–2.43) | |
| Q2 | 189 | 1.05 | (0.81–1.37) | 38 | 0.81 | (0.50–1.33) | 50 | 0.92 | (0.46–1.85) | 84 | 1.28 | (0.85–1.93) | 17 | 0.75 | (0.31–1.84) | |
| Q1 low | 167 | 0.97 | (0.72–1.31) | 42 | 0.88 | (0.51–1.51) | 35 | 0.72 | (0.32–1.62) | 59 | 1.05 | (0.66–1.70) | 31 | 1.29 | (0.55–3.02) | |
| p-trendf | 0.96 | 0.53 | 0.69 | 0.72 | 0.87 | |||||||||||
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| Restaurant environment indexg | 0.65 | |||||||||||||||
| 0h | 176 | 1.00 | 35 | 1.00 | 35 | 1.00 | 85 | 1.00 | 21 | 1.00 | ||||||
| Q1 low | 198 | 0.97 | (0.76–1.23) | 42 | 1.23 | (0.71–2.14) | 45 | 0.79 | (0.44–1.43) | 86 | 0.95 | (0.67–1.34) | 25 | 1.27 | (0.57–2.81) | |
| Q2 | 190 | 0.95 | (0.75–1.20) | 51 | 1.08 | (0.65–1.80) | 41 | 0.94 | (0.55–1.61) | 75 | 0.86 | (0.61–1.22) | 23 | 1.21 | (0.57–2.57) | |
| Q3 | 184 | 0.92 | (0.73–1.17) | 55 | 0.88 | (0.53–1.48) | 30 | 1.06 | (0.60–1.90) | 79 | 0.87 | (0.62–1.23) | 20 | 1.21 | (0.54–2.72) | |
| Q4 & <1 | 170 | 0.96 | (0.76–1.23) | 79 | 1.12 | (0.68–1.83) | 23 | 1.25 | (0.71–2.23) | 59 | 0.85 | (0.58–1.24) | 9 | 0.80 | (0.31–2.04) | |
| Q4 & ≥1 | 19 | 0.85 | (0.54–1.33) | 9 | 1.32 | (0.62–2.81) | 1 | 0.31 | (0.04–2.25) | 9 | 1.02 | (0.52–1.97) | 0 | |||
| No restaurants | 44 | 1.22 | (0.79–1.87) | 14 | 0.59 | (0.21–1.70) | 12 | 2.58d | (1.13–5.89) | 14 | 1.54 | (0.86–2.77) | 4 | 0.63 | (0.24–1.69) | |
| p-trendf | 0.55 | 0.80 | 0.44 | 0.29 | 0.41 | |||||||||||
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| Retail food environment indexi | 0.27 | |||||||||||||||
| 0i | 33 | 0.92 | (0.62–1.38) | 8 | 1.96 | (0.80–4.81) | 8 | 0.90 | (0.40–2.04) | 12 | 0.65 | (0.35–1.20) | 5 | 1.42 | (0.52–3.90) | |
| Q1 low | 206 | 1.00 | 48 | 1.00 | 36 | 1.00 | 109 | 1.00 | 13 | 1.00 | ||||||
| Q2 | 226 | 1.15 | (0.95–1.39) | 74 | 1.24 | (0.85–1.80) | 31 | 0.84 | (0.50–1.40) | 99 | 1.19 | (0.89–1.59) | 22 | 1.58 | (0.77–3.21) | |
| Q3 | 208 | 1.04 | (0.85–1.28) | 53 | 0.84 | (0.56–1.27) | 47 | 1.06 | (0.63–1.76) | 83 | 1.02 | (0.75–1.39) | 25 | 1.89 | (0.87–4.12) | |
| Q4 high | 273 | 1.11 | (0.91–1.36) | 86 | 1.15 | (0.77–1.73) | 57 | 0.97 | (0.59–1.59) | 97 | 0.95 | (0.69–1.30) | 33 | 2.14d | (1.00–4.57) | |
| No retail food | 35 | 1.08 | (0.69–1.68) | 16 | 2.68d | (1.02–7.03) | 8 | 0.83 | (0.30–2.33) | 7 | 0.73 | (0.31–1.71) | 4 | 1.00 | (0.31–3.22) | |
| p-trendf | 0.32 | 0.77 | 0.81 | 0.94 | 0.056 | |||||||||||
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| Number of recreational facilitiesk | 0.50 | |||||||||||||||
| 3+ | 302 | 1.00 | 69 | 1.00 | 82 | 1.00 | 113 | 1.00 | 38 | 1.00 | ||||||
| 2 | 189 | 1.10 | (0.91–1.34) | 68 | 1.28 | (0.91–1.80) | 25 | 0.85 | (0.53–1.38) | 83 | 1.14 | (0.84–1.54) | 13 | 0.89 | (0.45–1.79) | |
| 1 | 242 | 1.15 | (0.95–1.39) | 62 | 1.15 | (0.77–1.70) | 47 | 1.29 | (0.84–1.99) | 107 | 1.02 | (0.76–1.39) | 26 | 1.70 | (0.94–3.08) | |
| 0 | 248 | 1.04 | (0.85–1.29) | 86 | 1.06 | (0.72–1.57) | 33 | 0.99 | (0.58–1.70) | 104 | 0.98 | (0.70–1.36) | 25 | 1.37 | (0.75–2.49) | |
| p-trendf | 0.45 | 0.95 | 0.74 | 0.42 | 0.75 | |||||||||||
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| Commute by car/motorcyclee | 0.72 | |||||||||||||||
| Q1 low | 177 | 1.00 | 65 | 1.00 | 20 | 1.00 | 77 | 1.00 | 15 | 1.00 | ||||||
| Q2 | 162 | 0.83 | (0.67–1.05) | 66 | 1.23 | (0.86–1.78) | 24 | 0.96 | (0.49–1.88) | 60 | 0.65d | (0.45–0.94) | 12 | 0.57 | (0.26–1.25) | |
| Q3 | 202 | 0.97 | (0.77–1.22) | 52 | 1.21 | (0.83–1.78) | 41 | 1.15 | (0.57–2.31) | 86 | 0.77 | (0.54–1.12) | 23 | 1.12 | (0.50–2.50) | |
| Q4 | 217 | 0.84 | (0.65–1.08) | 51 | 1.16 | (0.75–1.80) | 44 | 0.91 | (0.44–1.89) | 92 | 0.66d | (0.44–1.00) | 30 | 0.85 | (0.37–1.95) | |
| Q5 high | 222 | 0.85 | (0.66–1.11) | 51 | 1.22 | (0.75–1.97) | 58 | 1.20 | (0.60–2.41) | 91 | 0.66 | (0.43–1.01) | 22 | 0.60 | (0.26–1.38) | |
| p-trendf | 0.35 | 0.59 | 0.58 | 0.17 | 0.39 | |||||||||||
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| Total number of businessesl | 0.048 | |||||||||||||||
| Q5 high | 206 | 1.00 | 46 | 1.00 | 64 | 1.00 | 66 | 1.00 | 30 | 1.00 | ||||||
| Q4 | 202 | 1.12 | (0.91–1.38) | 69 | 1.17 | (0.77–1.77) | 48 | 1.19 | (0.77–1.85) | 69 | 1.16 | (0.80–1.68) | 16 | 0.87 | (0.44–1.71) | |
| Q3 | 172 | 1.02 | (0.81–1.28) | 54 | 0.79 | (0.49–1.28) | 23 | 0.92 | (0.53–1.60) | 72 | 1.21 | (0.83–1.75) | 23 | 1.34 | (0.67–2.67) | |
| Q2 | 195 | 1.13 | (0.89–1.43) | 56 | 1.03 | (0.64–1.64) | 22 | 0.91 | (0.49–1.67) | 100 | 1.34 | (0.91–1.95) | 17 | 0.98 | (0.48–2.00) | |
| Q1 low | 206 | 1.15 | (0.89–1.49) | 60 | 0.91 | (0.53–1.56) | 30 | 1.17 | (0.62–2.20) | 100 | 1.45 | (0.96–2.21) | 16 | 0.74 | (0.33–1.63) | |
| p-trendf | 0.37 | 0.48 | 0.96 | 0.07 | 0.63 | |||||||||||
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| Traffic densitym | 0.78 | |||||||||||||||
| Q1 low | 199 | 1.00 | 53 | 1.00 | 38 | 1.00 | 85 | 1.00 | 23 | 1.00 | ||||||
| Q2 | 205 | 1.15 | (0.92–1.43) | 55 | 1.06 | (0.66–1.71) | 41 | 1.46 | (0.88–2.40) | 89 | 1.08 | (0.78–1.49) | 20 | 1.10 | (0.56–2.18) | |
| Q3 | 174 | 1.02 | (0.81–1.29) | 57 | 0.98 | (0.61–1.57) | 27 | 1.14 | (0.64–2.02) | 75 | 1.01 | (0.72–1.42) | 15 | 0.81 | (0.39–1.69) | |
| Q4 | 182 | 1.10 | (0.87–1.39) | 64 | 1.08 | (0.67–1.74) | 42 | 1.38 | (0.83–2.28) | 54 | 0.92 | (0.63–1.34) | 22 | 0.95 | (0.45–1.98) | |
| Q5 high | 221 | 1.29d | (1.03–1.61) | 56 | 1.22 | (0.76–1.96) | 39 | 1.47 | (0.84–2.57) | 104 | 1.23 | (0.89–1.70) | 22 | 0.95 | (0.47–1.91) | |
| p-trendf | 0.056 | 0.40 | 0.30 | 0.34 | 0.77 | |||||||||||
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| Street connectivitye, n | 0.31 | |||||||||||||||
| Q5 high | 152 | 1.00 | 66 | 1.00 | 27 | 1.00 | 46 | 1.00 | 13 | 1.00 | ||||||
| Q4 | 178 | 1.17 | (0.93–1.45) | 79 | 1.42d | (1.01–1.99) | 24 | 0.91 | (0.52–1.60) | 59 | 1.01 | (0.68–1.49) | 16 | 1.32 | (0.63–2.75) | |
| Q3 | 193 | 1.18 | (0.94–1.49) | 54 | 1.26 | (0.86–1.85) | 36 | 0.99 | (0.55–1.79) | 82 | 1.23 | (0.84–1.82) | 21 | 1.41 | (0.70–2.83) | |
| Q2 | 193 | 0.93 | (0.74–1.18) | 34 | 0.73 | (0.46–1.15) | 46 | 0.82 | (0.45–1.47) | 93 | 1.07 | (0.74–1.56) | 20 | 0.98 | (0.47–2.05) | |
| Q1 low | 265 | 1.10 | (0.86–1.41) | 52 | 1.23 | (0.77–1.95) | 54 | 0.83 | (0.45–1.55) | 127 | 1.19 | (0.81–1.76) | 32 | 1.10 | (0.52–2.30) | |
| p-trendf | 0.89 | 0.80 | 0.49 | 0.37 | 0.86 | |||||||||||
Adjusted for clustering effect of block group, age, race/ethnicity, body mass index, family history of colorectal cancer, history of intestinal polyps, education, pack-years of smoking, multivitamin use, nonsteroidal anti-inflammatory medication use, alcohol consumption, vigorous physical activity, history of diabetes, calories, red meat, dietary fiber, calcium, folacin, vitamin D, and all of the neighborhood variables presented in the table; age was the time metric.
Heterogeneity of the trend across race/ethnicity, excluding missing values, no restaurants for restaurant environment index, and no retail food for retail food environment.
Adjusted for clustering effect of block group, age, body mass index, family history of colorectal cancer, history of intestinal polyps, education, pack-years of smoking, multivitamin use, nonsteroidal anti-inflammatory medication use, alcohol consumption, vigorous physical activity, history of diabetes, calories, red meat, dietary fiber, calcium, folacin, vitamin D, and all of the neighborhood variables presented in the table; age wast the time metric.
p-value 0.01–<0.05
Census 1990 block-group level measures; quintiles based on Los Angeles County distribution.
p-trend analysis excluding missing values, no restaurants, and no retail food.
Residential buffer measure within a 1600 meter network distance; ratio of the average number of fast food restaurants to other restaurants; quartiles based on sample distribution.
No fast food restaurants, but other restaurants.
Residential buffer measure within a 1600 meter network distance; ratio of the average number of convenience stores, liquor stores, and fast food restaurants to supermarkets and farmers' markets; quartiles based on sample distribution.
No convenience stores, liquor stores, or fast food restaurants, but supermarkets or farmers' markets
Within a 1600 meter network distance.
Annual average number of businesses that were active during a 3-year window within a 1600 meter network distance; quintiles based on sample distribution.l
Traffic density within a 500 meter network distance; vehicle kilometers traveled (VKmT); quintiles based on sample distribution.
Ratio of actual number of street segments to maximum possible number of intersections.
Abbreviations: No., number of cases of invasive colorectal cancer; HR, hazard rate ratio; CI, confidence interval