Built environment (BE) and cancer: a systematic review of the BE's impact during the treatment journey and patient outcomes
Clinical Snapshot
PICO Framework
| P — Population | Cancer patients during treatment phase |
| I — Intervention | Built environment characteristics (urban features like transportation, green spaces, food environment; architectural features like design, aesthetics) |
| C — Comparator | Different built environment exposures or absence of specific environmental features |
| O — Outcomes | Physical activity, survival and mortality, quality of life, mental health status |
Bottom Line
This systematic review examines how built environment factors affect cancer patients during treatment, identifying 31 studies that explored relationships between environmental features (green spaces, transportation, aesthetics) and patient outcomes. While positive associations were found between certain built environment characteristics and physical activity, quality of life, and mental health, the evidence remains inconsistent across studies. The review highlights an important but understudied area in cancer care, suggesting that urban planning and healthcare facility design could potentially improve patient outcomes. However, the lack of quantitative synthesis, unclear methodology, and inconsistent findings limit the strength of recommendations. Clinicians should consider built environment factors when discussing treatment plans with patients, particularly regarding access to green spaces and transportation, but should not make major practice changes based on this evidence alone.
Key Findings
P Value: Not reported
Effect Size: Not quantified - qualitative synthesis only
Primary Outcome: Physical activity (most analyzed outcome in 11 articles)
Nnt Or Sensitivity: Not applicable - observational systematic review
Confidence Interval: Not reported
Clinical Application
Limited by inconsistent evidence base and lack of standardized built environment interventions Relevant to Australian cancer care planning, particularly for regional cancer centers and urban planning around major hospitals like Peter MacCallum Cancer Centre Cancer patients during active treatment phase across various cancer types
Abstract
The role of the built environment (BE) in cancer research has been extensively explored in prevention, focusing on its influence as a determinant of exposure to carcinogens and a lifestyle shaper, particularly through geographic accessibility to resources like transportation, healthy food, and diagnostic centers. However, the BE's role and influence during the treatment period and its connection with patient outcomes remain comparatively understudied. This systematic review employed the CDC definition of BE, following PRISMA guidelines and AI-driven software (ASReview) for a thorough and efficient literature review. A total of 31 articles were identified (27 database, 4 snowballing) that examined the BE's role during the treatment phase. These studies investigated diverse BE characteristics including urban features (e.g., transportation, green environment, food environment) and architectural features (e.g., design, aesthetics) during the cancer patient treatment journey. Among the included studies, the most analyzed outcomes were Physical Activity (PA) (11 articles), followed by survival and mortality (9 articles). Findings revealed positive associations between specific BE characteristics-such as green spaces, accessibility, transportation options, and aesthetics-and cancer patients' physical activity levels, quality of life, and mental health status; however, findings are inconsistent. These results underscore the potential of integrating urban and architectural BE analysis to enhance the psychosocial dimensions of cancer treatment, improve healthcare delivery, and open new pathways for research strategies.
References
- 1.Salas Carretero, R., Perillo, M., Lorenzini, A., & Boffetta, P. (2026). Built environment (BE) and cancer: a systematic review of the BE's impact during the treatment journey and patient outcomes. Cancer Causes & Control. https://doi.org/10.1016/j.ssmph.2018.07.001
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