Violence against Women Raises Risk of Cervical Cancer.
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.
Coker
Ann L
AL
Department of Obstetrics and Gynecology, University of Kentucky, Lexington, KY 40536-0293, USA. ann.coker@uky.edu
Hopenhayn
Claudia
C
DeSimone
Christopher P
CP
Bush
Heather M
HM
Crofford
Leslie
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018585:Battered Women / Q000523:psychology / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D019548:Crime Victims / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007629:Kentucky / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011902:Rape / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013179:Spouse Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult