  Prostate cancer is one of the leading causes of cancer-related mortality
among men in the U.S. We examined the role of neighborhood obesogenic
attributes on prostate cancer risk and mortality in the Southern Community
Cohort Study (SCCS). From 34,166 SCCS male participants, 28,356 were included
in the analysis. We assessed relationship between neighborhood socioeconomic
status (nSES) and neighborhood obesogenic environment indices including
restaurant environment index, retail food environment index, parks,
recreational facilities, and businesses and prostate cancer risk and mortality
by controlling for individual-level factors using a multivariable Cox
proportional hazards model. We further stratified prostate cancer risk analysis
by race and body mass index (BMI). Median follow-up time was 133 months, and
mean age was 51.62 years. There were 1,524 (5.37%) prostate cancer diagnoses
and 98 (6.43%) prostate cancer deaths during follow-up. Compared to
participants residing in wealthiest quintile, those residing in the poorest
quintile had a higher risk of prostate cancer, particularly among non-obese men
with a BMI less than 30. The restaurant environment index was associated with a
higher prostate cancer risk in overweight (BMI equal or greater 25) White men.
Obese Black individuals without any neighborhood recreational facilities had a
42% higher risk compared to those with any access. Compared to residents in
wealthiest quintile and most walkable area, those residing within the poorest
quintile or the least walkable area had a higher risk of prostate cancer death.
