ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2023
The Association of Neighborhood Characteristics and Frailty in Childhood Cancer Survivors: A Report from the St. Jude Lifetime Cohort Study.
Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 8 citations in OpenAlex.
- Frailty and neurocognitive impairments in Chinese survivors of childhood cancer.Journal of cancer survivorship : research and practice · 2026Article
- Person-environment interaction processes in frailty: a scoping review.The Gerontologist · 2026Article
- Pain and frailty progression in adult survivors of childhood cancer: a report from the St Jude Lifetime Cohort study.The lancet. Healthy longevity · 2026Article
- Neurocognitive and Emotional Outcomes in Childhood Cancer: A Developmental Perspective.Current oncology (Toronto, Ont.) · 2025Review
- Patient Characteristics and Neighborhood-Level Social Determinants of Health Associated With Childhood Cancer Survivor Follow-Up at Urban Cancer Centers.Pediatric blood & cancer · 2025Article
- Neighborhood vulnerability and associations with poor health-related quality of life among adult survivors of childhood cancer.JNCI cancer spectrum · 2024Article
- Morbidity and mortality among children, adolescents, and young adults with cancer over six decades: a Swedish population-based cohort study (the Rebuc study).The Lancet regional health. Europe · 2024Article
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13 authors at 3 institutions in 1 country.
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Abstract
backgroundChildhood cancer survivors experience reduced physiologic reserve, or frailty, earlier and more frequently than peers. In other populations, frailty is impacted by one's neighborhood. This study's purpose was to evaluate associations between neighborhood characteristics and frailty in childhood cancer survivors.
methodsParticipants in the St. Jude Lifetime Cohort Study with geocoded residential addresses were analyzed. Pre-frailty/Frailty was defined as having 1-2/≥3 of sarcopenia, muscle weakness, poor endurance, slow walking speed, and exhaustion from direct assessments. Neighborhood characteristics [e.g., access to exercise opportunities and healthy food, neighborhood socioeconomic status (nSES), and rurality/urbanicity] were determined using publicly available geospatial data. Nested multivariable logistic regression models identified associations between neighborhood characteristics and pre-frailty/frailty, adjusting for chronic health conditions, individual health behaviors and socio-demographics, and high-risk cancer treatment exposures.
resultsFor our cohort (N = 3,806, 46.79% female, 81.40% white, mean age 33.63±9.91 years), compared with non-frail survivors (n = 2,573; 67.6%), pre-frail (n = 900; 23.6%) and frail survivors (n = 333; 8.7%) were more likely to live in neighborhoods with decreased exercise opportunities (frail OR: 1.62, 1.26-2.09), reduced healthy food access (pre-frail OR: 1.28, 1.08-1.51; frail OR: 1.36, 1.06-1.75), and lower nSES (pre-frail OR: 1.31, 1.12-1.52; frail OR: 1.64, 1.30-2.07). Participants had 8% increased odds (95% confidence interval, 2%-14%) of being pre-frail/frail if they lived in "resource poor" neighborhoods as opposed to "resource rich" neighborhoods after adjusting for other pre-frailty/frailty risk factors.
conclusionsThe neighborhood a childhood cancer survivor resides in as an adult is associated with pre-frailty/frailty. IMPACT: This study provides valuable information for creating interventions using neighborhood-level factors to mitigate frailty and improve health outcomes in survivors. See related commentary by Bhandari and Armenian, p. 997.
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