A Critical Need to Examine the Lack of Access to Healthy Quality Foods and Its Association With Cancer Mortality—A Clarion Call for Multilevel Research and Interventions
Menée aux Etats-Unis sur la période 2010-2020, cette étude analyse l'association entre le type de lieu de restauration accessible (épiceries, marchés fermiers, restauration rapide) et la mortalité par cancer lié à l'obésité
Since the landmark review by Doll and Peto estimating the percentage of cancer deaths attributed to diet and other lifestyle factors more than 40 years ago, there has been a growing body of epidemiological and intervention research to identify and address modifiable risk factors associated with high rates of cancer morbidity and mortality in the US and globally. Yet, whereas historically, studies targeted individual-level drivers, evidence has shown that cancer outcomes are significantly associated with the social and structural determinants of health—specifically, the conditions and environments where people are born, live, learn, work, play, and worship and the social and political structures that shape these conditions. In this issue of JAMA Oncology, Bevel et al conducted a cross-sectional ecological study examining the association of “food deserts” and “food swamps” with obesity-related cancer mortality across all US counties in the past decade. As the authors indicate, obesity and overweight status, of which diet is a major risk factor, has been associated with 13 different types of cancer (endometrial, esophageal adenocarcinoma, gastric cardia, liver, kidney, multiple myeloma, meningioma, pancreatic, colorectal, gallbladder, breast, ovarian, and thyroid) accounting for 40% of all cancers diagnosed in the US each year. The study reported that US counties or county equivalents that had a high food swamp score had 77% increased odds of having obesity-related cancer mortality. The study also found a positive dose-response relationship where counties with high food swamp scores had greater than 2-fold increased odds of high obesity-related cancer mortality than those counties with reportedly lower food swamp scores. This study addresses a critical gap in the field and provides data that begins to disentangle the complex intersection between obesity-related cancer mortality and social determinants of health and uncovers the misnomer of the generalizability of the concept of diet being a modifiable risk factor.
JAMA Oncology , commentaire, 2022