Héctor E Alcalá1, Emma Mitchell2, Jessica Keim-Malpass2. 1. 1 Department of Public Health, University of Virginia , Charlottesville, Virginia. 2. 2 School of Nursing, University of Virginia , Charlottesville, Virginia.
Abstract
BACKGROUND: Adverse childhood experiences (ACEs) have been associated with an increased risk of a variety of diseases, including cancer. However, research has largely ignored how ACEs impact cancer screening, a potential intermediate outcome. As such, the present study examined the association between ACEs and ever and recent use of Papanicolaou (Pap) test, among women aged 21 and older. MATERIALS AND METHODS: Analyses used the 2009 Tennessee Behavioral Risk Factor Surveillance System (n = 1527) to model odds of ever and recently (within the last 3 years) engaging in Pap tests screening from nine different adversities. Bivariate and multivariate logistic regression models were run to accomplish this. RESULTS: In bivariate and multivariate models, living in a household in which adults treated each other violently increased odds of ever receiving a Pap test. In bivariate models, physical and sexual abuse was associated with decreased odds of receiving a recent Pap test. After accounting for confounders, only the latter association remained significant. CONCLUSIONS: Results highlight a potential mechanism by which early childhood experiences can impact the development of cervical cancer. Providers of care should consider modifications to their screening practices, including screening for child abuse, to better serve all women.
BACKGROUND: Adverse childhood experiences (ACEs) have been associated with an increased risk of a variety of diseases, including cancer. However, research has largely ignored how ACEs impact cancer screening, a potential intermediate outcome. As such, the present study examined the association between ACEs and ever and recent use of Papanicolaou (Pap) test, among women aged 21 and older. MATERIALS AND METHODS: Analyses used the 2009 Tennessee Behavioral Risk Factor Surveillance System (n = 1527) to model odds of ever and recently (within the last 3 years) engaging in Pap tests screening from nine different adversities. Bivariate and multivariate logistic regression models were run to accomplish this. RESULTS: In bivariate and multivariate models, living in a household in which adults treated each other violently increased odds of ever receiving a Pap test. In bivariate models, physical and sexual abuse was associated with decreased odds of receiving a recent Pap test. After accounting for confounders, only the latter association remained significant. CONCLUSIONS: Results highlight a potential mechanism by which early childhood experiences can impact the development of cervical cancer. Providers of care should consider modifications to their screening practices, including screening for child abuse, to better serve all women.
Entities:
Keywords:
adverse childhood experiences; cancer; cancer screening; cervical cancer; child abuse; pap test
Authors: Sarah Gupta; Christina Palmer; Elisabeth M Bik; Juan P Cardenas; Harold Nuñez; Laurens Kraal; Sara W Bird; Jennie Bowers; Alison Smith; Nathaniel A Walton; Audrey D Goddard; Daniel E Almonacid; Susan Zneimer; Jessica Richman; Zachary S Apte Journal: Front Public Health Date: 2018-04-09