How does the built environment relate to preventing cancer? A multidisciplinary scoping review

Globally, the increasing rate of preventable cancers suggests a need to understand how features of the built environment shape exposures to and distributions of cancer risk among various populations. In 2015, cancer was the second most common cause of death globally, with more than 8.5 million attributable fatalities. Estimates would place 45-85% of these cancers as preventable based on environment and lifestyle factors. This scoping review, authored by HEAL members Alexander Wray and Dr. Leia Minaker, examined 268 studies from over 13 subject databases published since 1990 about how the built environment is discussed in the context of cancer prevention.

The review identified a clear need for more cross-disciplinary research about the role of environmental factors in cancer etiology and control. Over 20% of the results included in the review were found outside of traditional medical science sources, leading to the need for more interdisciplinary work. Engagement across traditional disciplinary boundaries to form a new field of cancer‐environment studies that leverages the study designs of the medical and natural sciences and the theoretical grounding of the social sciences could potentially create more impactful and nuanced research. Furthermore, many studies captured in the review were cross-sectional designs limiting causal determinations. However, new longitudinal and network-based research designs could prove to help establish relationships between built environment factors, cancer risk factors, and disease outcomes. Finally, the review notes the potential role of local government in preventing cancer through their land use decisions, supporting sustainable transportation, and leveraging eminent domain powers. Therefore, changes to land use, transportation, and urban design policies could have a meaningful impact on the prevention of cancer, considering more than 90% of the world’s population is expected to live in urban areas by 2100.

This work was supported by the Canadian Cancer Society (grant 704744) and a University of Waterloo Undergraduate Research Initiative award.


Keywords: cancer, built environment, literature review, epidemiology, urban planning

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