Childhood maltreatment as a risk factor for cancer: Findings from a population-based survey of Canadian adults
Background: Childhood maltreatment (CM) is an established risk factor for various mental and substance use disorders. This study adds to existing evidence that CM may also be a risk factor for cancer. Methods: Based on data from a sample of 9,783 men and 12,132 women from the 2012 Canadian Community Health Survey - Mental Health (CCHS-MH), this analysis explores mediated associations between cancer in adulthood and different levels of exposure to three types of CM—childhood physical abuse (CPA), childhood sexual abuse (CSA), and childhood exposure to intimate partner violence (CEIPV). “Cancer” was defined as an affirmative response to either of these questions: ‘‘Do you have cancer?’’ or ‘‘Have you ever been diagnosed with cancer?’’ The potential mediators were: smoking, depression, alcohol abuse/dependence, life stress, obesity, and physical activity. Results: For women, but not men, having experienced CM was significantly associated with a cancer diagnosis in adulthood, even when effects due to age and socio-demographic characteristics were controlled. Smoking, life stress, depression, and alcohol abuse/dependence reduced the strength of the association between CM and cancer in women. However, most associations remained statistically significant when controlling for effects due to these behavioural and other mediators. Evidence indicated a “dose-response” relationship, in that the likelihood of reporting cancer increased with the number of abuse types (CPA, CSA, CEIPV) reported, and with the severity of CPA. Conclusions: The analyses suggest an association between CM and cancer in women, even when the effects of known risk factors were taken into account. The association was graded, becoming stronger as CM exposure increased. Implications for the provision of cancer screening and other health care services to women with histories of CM to reduce health disparities are discussed. Keywords “child abuse” “child maltreatment” “ACE” “adverse childhood experiences” “risk factors” “gender differences” “population health survey” “chronic disease”
Figure 1
Due to technical limitations tables are available as a download in the Supplementary Files
Posted 18 Dec, 2019
On 29 Jan, 2020
On 18 Dec, 2019
On 16 Dec, 2019
On 15 Dec, 2019
On 15 Dec, 2019
On 10 Dec, 2019
Received 09 Dec, 2019
On 27 Nov, 2019
Received 27 Nov, 2019
On 22 Nov, 2019
On 21 Nov, 2019
Invitations sent on 21 Nov, 2019
On 20 Nov, 2019
On 20 Nov, 2019
On 14 Oct, 2019
Received 05 Oct, 2019
Received 05 Oct, 2019
On 24 Sep, 2019
On 24 Sep, 2019
Invitations sent on 21 Sep, 2019
On 19 Jun, 2019
On 18 Jun, 2019
On 18 Jun, 2019
Childhood maltreatment as a risk factor for cancer: Findings from a population-based survey of Canadian adults
Posted 18 Dec, 2019
On 29 Jan, 2020
On 18 Dec, 2019
On 16 Dec, 2019
On 15 Dec, 2019
On 15 Dec, 2019
On 10 Dec, 2019
Received 09 Dec, 2019
On 27 Nov, 2019
Received 27 Nov, 2019
On 22 Nov, 2019
On 21 Nov, 2019
Invitations sent on 21 Nov, 2019
On 20 Nov, 2019
On 20 Nov, 2019
On 14 Oct, 2019
Received 05 Oct, 2019
Received 05 Oct, 2019
On 24 Sep, 2019
On 24 Sep, 2019
Invitations sent on 21 Sep, 2019
On 19 Jun, 2019
On 18 Jun, 2019
On 18 Jun, 2019
Background: Childhood maltreatment (CM) is an established risk factor for various mental and substance use disorders. This study adds to existing evidence that CM may also be a risk factor for cancer. Methods: Based on data from a sample of 9,783 men and 12,132 women from the 2012 Canadian Community Health Survey - Mental Health (CCHS-MH), this analysis explores mediated associations between cancer in adulthood and different levels of exposure to three types of CM—childhood physical abuse (CPA), childhood sexual abuse (CSA), and childhood exposure to intimate partner violence (CEIPV). “Cancer” was defined as an affirmative response to either of these questions: ‘‘Do you have cancer?’’ or ‘‘Have you ever been diagnosed with cancer?’’ The potential mediators were: smoking, depression, alcohol abuse/dependence, life stress, obesity, and physical activity. Results: For women, but not men, having experienced CM was significantly associated with a cancer diagnosis in adulthood, even when effects due to age and socio-demographic characteristics were controlled. Smoking, life stress, depression, and alcohol abuse/dependence reduced the strength of the association between CM and cancer in women. However, most associations remained statistically significant when controlling for effects due to these behavioural and other mediators. Evidence indicated a “dose-response” relationship, in that the likelihood of reporting cancer increased with the number of abuse types (CPA, CSA, CEIPV) reported, and with the severity of CPA. Conclusions: The analyses suggest an association between CM and cancer in women, even when the effects of known risk factors were taken into account. The association was graded, becoming stronger as CM exposure increased. Implications for the provision of cancer screening and other health care services to women with histories of CM to reduce health disparities are discussed. Keywords “child abuse” “child maltreatment” “ACE” “adverse childhood experiences” “risk factors” “gender differences” “population health survey” “chronic disease”
Figure 1
Due to technical limitations tables are available as a download in the Supplementary Files