Residential Fast-Food Exposures, Colorectal Cancer-Specific, and All-Cause Mortality: A Retrospective Study of CRC...

Indicators of a poorer food environment, such as low food environment index scores, food deserts, and food swamps, have been linked to increased mortality and decreased survival among colorectal cancer (CRC) cases. This retrospective study of 47,807 primary CRC cases from the Kentucky Cancer Registry (KCR) database diagnosed between January 1995 and December 2021 used Cox-proportional-hazard (Cox-PH) regression models to estimate adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) for CRC-specific mortality and all-cause mortality associated with residential fast-food exposures. Residential fast-food exposures were not associated with CRC-specific mortality. However, residing within 0.5-mile of a fast-food outlet was associated with a 7% higher hazard of all-cause mortality (aHR: 1.07; 95% CI: 1.02-1.11; P-for trend: 0.001) compared with those living more than 3 miles away. Similar associations for all-cause mortality were observed for higher fast-food coverage (aHR: 1.05; 95% CI: 1.02-1.07; P-value: 0.001) and fast-food density (aHR: 1.05; 95% CI: 1.02-1.07; P-value: 0.001) within a mile radius. Residential fast-food exposures, such as closer proximity, higher fast-food coverage and greater fast-food density, may contribute to a modest increase in all-cause mortality among individuals diagnosed with CRC. These findings underscore the potential role of neighborhood food environments in the survival of CRC patients.