Cancer
Food Environment Index and Pancreatic Cancer Survival in North Carolina Shenghui Wu* Shenghui Wu Leilani Tseng Yanning Liu
Background: Exploring the potential role of the food environment on cancer survival could facilitate prevention and control approaches to improve cancer survivorship. This study examined the associations between food environment index (FEI) and survival for pancreatic cancer in North Carolina.
Methods: This retrospective cohort study included 30,361 patients diagnosed with overall cancer from January 1, 2000 to December 31, 2022 from the North Carolina Cancer Central Registry. The individual-level demographic, tumor, and treatment information were provided by the North Carolina Cancer Central Registry. FEI and other county-level exposures were obtained from the County Health Rankings & Roadmaps databases. The county-level food environment index is an indicator of access to healthy foods (0 is worst, 10 is best). Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between FEI and cancer survival after adjusting for individual-level and county-level covariates.
Results: Higher levels of FEI were associated with a statistically significant better survival for colorectal cancer (fully adjusted HR for every score increase=0.98, 95% CI 0.96, 0.995; P <0.0001; adjusted HR for the 3rd tertile vs. 1st tertile = 0.94, 95% CI 0.89, 0.99).
Conclusion: These results suggest that a healthy food environment, as measured by FEI, may be a protective factor for pancreatic cancer survival in North Carolina. To improve pancreatic cancer survival, further strategies to improve food environment at the county level are warranted.