Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Environ Res. 2024 Dec 1;262(Pt 1):119847. doi: 10.1016/j.envres.2024.119847. Epub 2024 Aug 24.
Neighborhood greenness may benefit long-term prostate cancer survivorship by promoting physical activity and social integration, and reducing stress and exposure to air pollution, noise, and extreme temperatures. We examined associations of neighborhood greenness and long-term physical and psychosocial quality of life in prostate cancer survivors in the Health Professionals Follow-up Study.
We included 1437 individuals diagnosed with non-metastatic prostate cancer between 2008 and 2016 across the United States. Neighborhood greenness within a 1230m buffer of each individual's mailing address was measured using the Landsat satellite image-based Normalized Difference Vegetation Index (NDVI). We fit generalized linear mixed effect models to assess associations of greenness (in quintiles) with longitudinal patient reported outcome measures on prostate cancer-specific physical and psychosocial quality of life, adjusting for time-varying individual- and neighborhood-level demographic factors and clinical factors.
The greatest symptom burden was in the sexual domain. More than half of survivors reported good memory function and the lack of depressive signs at diagnosis. In fully adjusted models, cumulative average greenness since diagnosis was associated with fewer vitality/hormonal symptoms (highest quintile, Q5, vs lowest quintile, Q1: mean difference: 0.46, 95% confidence interval [CI]: 0.81, -0.12). Other domains of physical quality of life (bowel symptoms, urinary incontinence, urinary irritation, and sexual symptoms) did not differ by greenness overall. Psychosocial quality of life did not differ by greenness overall (Q5 vs Q1, odds ratio [95% CI]: memory function: 1.01 [0.61, 1.73]; lack of depressive signs: 1.10 [0.63, 1.95]; and wellbeing: 1.17 [0.71, 1.91]).
During long-term prostate cancer survivorship, cumulative average 1230m greenness since diagnosis was associated with fewer vitality/hormonal symptoms. Other domains of physical quality of life and psychosocial quality of life did not differ by greenness overall. Limitations included potential non-differential exposure measurement error and NDVI's lack of time-activity pattern.
邻里的绿化可能通过促进身体活动和社会融合，以及减少压力和暴露于空气污染、噪音和极端温度，有益于长期前列腺癌的生存。我们研究了美国健康专业人员随访研究中，邻里绿化与前列腺癌幸存者长期身体和心理社会生活质量的关联。
我们纳入了 1437 名在 2008 年至 2016 年期间被诊断为非转移性前列腺癌的个体。通过基于陆地卫星图像的归一化差异植被指数（NDVI）测量每个个体邮寄地址 1230 米缓冲区的邻里绿化情况。我们拟合了广义线性混合效应模型，以评估绿化（五分位数）与前列腺癌特异性身体和心理社会生活质量的纵向患者报告结果测量之间的关联，同时调整了随时间变化的个体和邻里层面的人口统计学因素和临床因素。
最大的症状负担在性功能领域。超过一半的幸存者在诊断时报告了良好的记忆功能和没有抑郁迹象。在完全调整的模型中，自诊断以来的累计平均绿化与较少的活力/激素症状相关（最高五分位数，Q5，与最低五分位数，Q1：平均差异：0.46，95%置信区间[CI]：0.81，-0.12）。其他身体生活质量领域（肠道症状、尿失禁、尿道刺激和性功能障碍）的症状不因绿化而异。心理社会生活质量的总体情况不因绿化而异（Q5 与 Q1 相比，比值比[95%CI]：记忆功能：1.01[0.61,1.73]；缺乏抑郁迹象：1.10[0.63,1.95]；和幸福感：1.17[0.71,1.91]）。
在长期前列腺癌生存期间，自诊断以来的累计平均 1230 米绿化与较少的活力/激素症状相关。其他身体生活质量和心理社会生活质量的领域不因绿化而异。局限性包括潜在的非差异化暴露测量误差和 NDVI 缺乏时间活动模式。
