Urban greenness and survival in lung cancer patients: A registry-based cohort study in Beijing
Background: Previous studies have reported inverse associations between urban greenness and mortality. However, findings regarding contemporaneous and cumulative average greenness exposure are inconsistent. A potential explanation is the weak effects of greenness among the general population. This s...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-12-01
|
| Series: | Ecotoxicology and Environmental Safety |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0147651321011544 |
| _version_ | 1818353378826125312 |
|---|---|
| author | Lei Yang Fuyu Guo Ning Wang Shuo Liu Xi Zhang Huichao Li Qingyu Li Tao Xue Qingyang Xiao Xin Li Hengyi Liu Mingkun Tong Pengfei Li Aiguo Ren Jiafu Ji |
| author_facet | Lei Yang Fuyu Guo Ning Wang Shuo Liu Xi Zhang Huichao Li Qingyu Li Tao Xue Qingyang Xiao Xin Li Hengyi Liu Mingkun Tong Pengfei Li Aiguo Ren Jiafu Ji |
| author_sort | Lei Yang |
| collection | DOAJ |
| description | Background: Previous studies have reported inverse associations between urban greenness and mortality. However, findings regarding contemporaneous and cumulative average greenness exposure are inconsistent. A potential explanation is the weak effects of greenness among the general population. This study assessed the associations between contemporaneous and cumulative average greenness exposure and survival in lung cancer patients. Methods: An open cohort consisting of lung cancer patients enrolled from 1 January 2001 was studied. The cohort was followed up until 31 December 2018. We evaluated contemporaneous and cumulative greenness exposure using the normalized difference vegetation index (NDVI) within a 250 m buffer of each patient’s geocoded residential address. The association between NDVI and mortality was evaluated using both time-fixed and time-varying Cox models. Their difference was compared either. Results: In time-fixed Cox models, a 0.1-unit increment in contemporaneous and cumulative average NDVI was associated with 17% (95% confidence interval [CI], 15–18%) and 7% (95% CI, 5–8%) reductions in mortality rate, respectively. Time-varying Cox models consistently revealed significant associations, but their magnitudes were lower, at 2% (95% CI, 1–3%) for both contemporaneous and cumulative average NDVI. Compared to the time-fixed models, the time-varying ones exhibited better fit for the proportional hazard assumption in Cox regressions with more conservative results. Conclusion: Urban greenness is positively associated with an increased chance of survival in lung cancer patients. Compared to time-fixed Cox models, the results of time-varying Cox models were more conservative. This study confirms the beneficial health effects of urban greenness, which may facilitate the improvement of public health by urban green space planning. |
| first_indexed | 2024-12-13T19:08:35Z |
| format | Article |
| id | doaj.art-2af7b4cc88a74bd58aecece8b55ee0d6 |
| institution | Directory Open Access Journal |
| issn | 0147-6513 |
| language | English |
| last_indexed | 2024-12-13T19:08:35Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Ecotoxicology and Environmental Safety |
| spelling | doaj.art-2af7b4cc88a74bd58aecece8b55ee0d62022-12-21T23:34:28ZengElsevierEcotoxicology and Environmental Safety0147-65132021-12-01228113042Urban greenness and survival in lung cancer patients: A registry-based cohort study in BeijingLei Yang0Fuyu Guo1Ning Wang2Shuo Liu3Xi Zhang4Huichao Li5Qingyu Li6Tao Xue7Qingyang Xiao8Xin Li9Hengyi Liu10Mingkun Tong11Pengfei Li12Aiguo Ren13Jiafu Ji14Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, ChinaInstitute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USAKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, ChinaInstitute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China; Corresponding authors.State Key Joint Laboratory of Environment Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, ChinaState Environmental Protection Key Laboratory of Food Chain Pollution Control, Beijing Technology and Business University, Beijing 100048, ChinaInstitute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, ChinaInstitute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, ChinaInstitute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China; Advanced Institute of Information Technology, Peking University, Hangzhou 311215, ChinaInstitute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing 100142, China; Corresponding authors.Background: Previous studies have reported inverse associations between urban greenness and mortality. However, findings regarding contemporaneous and cumulative average greenness exposure are inconsistent. A potential explanation is the weak effects of greenness among the general population. This study assessed the associations between contemporaneous and cumulative average greenness exposure and survival in lung cancer patients. Methods: An open cohort consisting of lung cancer patients enrolled from 1 January 2001 was studied. The cohort was followed up until 31 December 2018. We evaluated contemporaneous and cumulative greenness exposure using the normalized difference vegetation index (NDVI) within a 250 m buffer of each patient’s geocoded residential address. The association between NDVI and mortality was evaluated using both time-fixed and time-varying Cox models. Their difference was compared either. Results: In time-fixed Cox models, a 0.1-unit increment in contemporaneous and cumulative average NDVI was associated with 17% (95% confidence interval [CI], 15–18%) and 7% (95% CI, 5–8%) reductions in mortality rate, respectively. Time-varying Cox models consistently revealed significant associations, but their magnitudes were lower, at 2% (95% CI, 1–3%) for both contemporaneous and cumulative average NDVI. Compared to the time-fixed models, the time-varying ones exhibited better fit for the proportional hazard assumption in Cox regressions with more conservative results. Conclusion: Urban greenness is positively associated with an increased chance of survival in lung cancer patients. Compared to time-fixed Cox models, the results of time-varying Cox models were more conservative. This study confirms the beneficial health effects of urban greenness, which may facilitate the improvement of public health by urban green space planning.http://www.sciencedirect.com/science/article/pii/S0147651321011544Urban greennessMortalitySurvivalLung cancerTime-varying exposureCox Proportional-Hazards regression |
| spellingShingle | Lei Yang Fuyu Guo Ning Wang Shuo Liu Xi Zhang Huichao Li Qingyu Li Tao Xue Qingyang Xiao Xin Li Hengyi Liu Mingkun Tong Pengfei Li Aiguo Ren Jiafu Ji Urban greenness and survival in lung cancer patients: A registry-based cohort study in Beijing Ecotoxicology and Environmental Safety Urban greenness Mortality Survival Lung cancer Time-varying exposure Cox Proportional-Hazards regression |
| title | Urban greenness and survival in lung cancer patients: A registry-based cohort study in Beijing |
| title_full | Urban greenness and survival in lung cancer patients: A registry-based cohort study in Beijing |
| title_fullStr | Urban greenness and survival in lung cancer patients: A registry-based cohort study in Beijing |
| title_full_unstemmed | Urban greenness and survival in lung cancer patients: A registry-based cohort study in Beijing |
| title_short | Urban greenness and survival in lung cancer patients: A registry-based cohort study in Beijing |
| title_sort | urban greenness and survival in lung cancer patients a registry based cohort study in beijing |
| topic | Urban greenness Mortality Survival Lung cancer Time-varying exposure Cox Proportional-Hazards regression |
| url | http://www.sciencedirect.com/science/article/pii/S0147651321011544 |
| work_keys_str_mv | AT leiyang urbangreennessandsurvivalinlungcancerpatientsaregistrybasedcohortstudyinbeijing AT fuyuguo urbangreennessandsurvivalinlungcancerpatientsaregistrybasedcohortstudyinbeijing AT ningwang urbangreennessandsurvivalinlungcancerpatientsaregistrybasedcohortstudyinbeijing AT shuoliu urbangreennessandsurvivalinlungcancerpatientsaregistrybasedcohortstudyinbeijing AT xizhang urbangreennessandsurvivalinlungcancerpatientsaregistrybasedcohortstudyinbeijing AT huichaoli urbangreennessandsurvivalinlungcancerpatientsaregistrybasedcohortstudyinbeijing AT qingyuli urbangreennessandsurvivalinlungcancerpatientsaregistrybasedcohortstudyinbeijing AT taoxue urbangreennessandsurvivalinlungcancerpatientsaregistrybasedcohortstudyinbeijing AT qingyangxiao urbangreennessandsurvivalinlungcancerpatientsaregistrybasedcohortstudyinbeijing AT xinli urbangreennessandsurvivalinlungcancerpatientsaregistrybasedcohortstudyinbeijing AT hengyiliu urbangreennessandsurvivalinlungcancerpatientsaregistrybasedcohortstudyinbeijing AT mingkuntong urbangreennessandsurvivalinlungcancerpatientsaregistrybasedcohortstudyinbeijing AT pengfeili urbangreennessandsurvivalinlungcancerpatientsaregistrybasedcohortstudyinbeijing AT aiguoren urbangreennessandsurvivalinlungcancerpatientsaregistrybasedcohortstudyinbeijing AT jiafuji urbangreennessandsurvivalinlungcancerpatientsaregistrybasedcohortstudyinbeijing |