Violence against Women Raises Risk of Cervical Cancer

Ann L. Coker · Claudia Hopenhayn · Christopher Philip DeSimone · Heather Bush · Leslie J. Crofford

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Intimate Partner and Family Violence Cervical Cancer and HPV Research Women's cancer prevention and management

Abstract

BACKGROUND: An emerging literature suggests that violence against women (VAW), particularly sexual violence, may increase the risk of acquiring a sexually transmitted infection (STI) and, therefore, may be associated with cervical cancer development. The purpose of this cross-sectional analysis was to determine if women who had experienced violence had higher prevalence rates of invasive cervical cancer. METHODS: Women aged 18-88 who joined the Kentucky Women's Health Registry (2006-2007) and completed a questionnaire were included in the sample. Multivariate logistic regression analyses were used to adjust odds ratio (OR) for confounders (e.g., age, education, current marital status, lifetime illegal drug use, and pack-years of cigarette smoking). RESULTS: Of 4732 participants with no missing data on violence, cervical cancer, or demographic factors, 103 (2.1%) reported ever having cervical cancer. Adjusting for demographic factors, smoking, and illegal drug use, experiencing VAW was associated with an increased prevalence of invasive cervical cancer (adjusted OR [aOR] = 2.6, 95% CI = 1.7-3.9). This association remained significant when looking at three specific types of VAW: intimate partner violence (IPV) (aOR = 2.7, 95% CI = 1.8-4.0), adult exposure to forced sex (aOR = 2.6, 95% CI = 1.6-4.3), and child exposure to sexual abuse (aOR = 2.4, 95% CI = 1.4-4.0). CONCLUSIONS: Rates of cervical cancer were highest for those experiencing all three types of VAW relative to those never experiencing VAW. Because VAW is common and has gynecological health effects, asking about VAW in healthcare settings and using this information to provide tailored healthcare may improve women's health outcomes.

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References

2002Health consequences of intimate partner violence 2000Full Report of the Prevalence, Incidence, and Consequences of Violence Against Women 2001Dating Violence Against Adolescent Girls and Associated Substance Use, Unhealthy Weight Control, Sexual Risk Behavior, Pregnancy, and Suicidality 2000Physical Health Consequences of Physical and Psychological Intimate Partner Violence 1998Prevalence, Incidence, and Consequences of Violence Against Women: Findings From the National Violence Against Women Survey.2003A Longitudinal Perspective on Dating Violence Among Adolescent and College-Age Women 1991Adult survivors of childhood sexual abuse and subsequent risk of HIV infection.2001Prevalence of violence and its implications for women’s health

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