title: Synergy between sexual abuse and cervical cancer in causing sexual dysfunction.
abstract: Experiencing a sexual abuse creates a life-long traumatic memory. The life-long effect of such abuse on sexuality, well-being, the risk of contracting cervical cancer, or problems after treatment for cervical cancer is not known. A population-based follow-up study in 1996-97 that used an anonymous postal questionnaire for data collection, 256 women with stage IB-IIA cervical cancer registered in 1991-92 in Sweden, and 350 women without cervical cancer frequency matched for age and region of residence, provided information. Among the women with a history of cervical cancer and the control women, 46 (18%) and 50 (15%), respectively, reported a history of sexual abuse. The follow-up was 1-70 years after the sexual abuse. The relative risk (with 95% confidence interval) of decreased well-being was 2.4 (1.1-5.2) among controls and 2.7 (1.1-6.4) among former cervical cancer patients. A history of both sexual abuse and cervical cancer gave a relative risk of 30.0 (7.0-129.0) for superficial dyspareunia. Sexual abuse increased the risk of sexual problems after treatment. The sexually abused cervical cancer patients were generally less willing than other patients to trade off possible maximal survival and forgo parts of the treatment. A history of sexual abuse and cervical cancer are both independent risk factors for sexual dysfunction and decreased well-being, and there may be a large synergy when both factors are combined. Diagnosis and treatment of cervical cancer may be improved by recognition of a sexual abuse history.
authors.affiliation: Gynecological Oncology, Department of Oncology and Pathology Radiumhemmet, Karolinska Institutet, Stockholm, Sweden. Karin.Bergmark@onkpat.ki.se
authors.forename: Karin
authors.initials: K
authors.lastname: Bergmark
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Avall-Lundqvist
authors.forename: Paul W
authors.initials: PW
authors.lastname: Dickman
authors.forename: Gunnar
authors.initials: G
authors.lastname: Steineck
authors.forename: Lars
authors.initials: L
authors.lastname: Henningsohn
mesh_terms: D000328:Adult; D000368:Aged; D018585:Battered Women / Q000523:psychology; D016022:Case-Control Studies; D016001:Confidence Intervals; D019548:Crime Victims / Q000523:psychology; D004414:Dyspareunia / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D007989:Libido; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012649:Self Concept; D012742:Sex Offenses / Q000523:psychology*; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D013548:Sweden; D002583:Uterine Cervical Neoplasms / Q000150:complications* / Q000523:psychology; D016387:Women's Health