title: Association of intimate partner violence and childhood sexual abuse with cancer-related well-being in women.
abstract: BACKGROUND
  Limited evidence suggests that intimate partner violence (IPV) may be associated with poorer cancer outcomes. We hypothesized that timing and type of IPV as well as childhood sexual abuse (CSA) may negatively affect depression, perceived stress, and cancer-related well-being.
  
  
  METHODS
  This was a cross-sectional study of women diagnosed with either breast, cervical, or colorectal cancer in the prior 12 months included in the Kentucky Cancer Registry. Consenting women were interviewed by phone (n=553). Multivariate analysis of covariance (MANCOVA) was used to determine the association between IPV (37% lifetime prevalence) and type, timing, and the range of correlated cancer-related well-being indicators, adjusting for confounding factors.
  
  
  RESULTS
  IPV (p=0.002) and CSA (p=0.03) were associated with the six correlated well-being indicators. Specifically, lifetime and current IPV were associated with lower Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) (p=0.006) and Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-SP) (p=0.03) scores, higher perceived stress at diagnosis (p=0.006), and depressive symptom scores at diagnosis (p<0.0001), whereas CSA was associated with lower FACT-B (p=0.02), increased number of comorbid conditions (p=0.03), and higher current stress levels (p=0.04). Current and past IPV, as well as psychologic abuse, were associated with poorer well-being among women with a recent cancer diagnosis.
  
  
  CONCLUSIONS
  Our results provide evidence that both IPV and CSA negatively influence cancer-related well-being indicators. These data suggest that identification of lifetime IPV and other stressors may provide information that healthcare providers can use to best support and potentially improve the well-being of female cancer patients.
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, University of Kentucky, Lexington, KY 40536-0293, USA. ann.coker@uky.edu
authors.forename: Ann L
authors.initials: AL
authors.lastname: Coker
authors.forename: Diane
authors.initials: D
authors.lastname: Follingstad
authors.forename: Lisandra S
authors.initials: LS
authors.lastname: Garcia
authors.forename: Corrine M
authors.initials: CM
authors.lastname: Williams
authors.forename: Tim N
authors.initials: TN
authors.lastname: Crawford
authors.forename: Heather M
authors.initials: HM
authors.lastname: Bush
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D018585:Battered Women / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D017579:Domestic Violence / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006305:Health Status Indicators; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D007629:Kentucky / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000453:epidemiology; D012042:Registries; D012747:Sexual Partners; D055815:Young Adult