Built environment (BE) and cancer: a systematic review of the BE’s impact during the treatment journey and patient outcomes

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.