Wyatt Gail E, Loeb Tamra Burns, Desmond Katherine A, Ganz Patricia A
Department of Psychiatry and Behavioral Sciences, School of Medicine, Division of Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA 90095-6900, USA.
J Clin Oncol. 2005 Feb 20;23(6):1261-9. doi: 10.1200/JCO.2005.01.150.
Little is known about a history of childhood sexual abuse (CSA) in breast cancer survivors and its relationship to sexual functioning after cancer. As part of a larger survey study examining sexuality and intimacy in breast cancer survivors, we conducted in-person interviews with a subsample of participants.
A total of 147 women in Los Angeles, CA, and Washington, DC, completed a structured interview that addressed sexual socialization and a history of sexual abuse. Trained female interviewers conducted the interviews. Descriptive statistics and regression analyses were used to examine the prevalence of CSA, and its potential impact on sexual health and functioning.
One in three women reported at least one CSA incident. Among women who had experienced CSA, 71% reported a single incident, and 22% reported a penetrative form of sexual contact. In multivariate regression analyses examining physical and psychological aspects of sexuality and body image, CSA was not a significant predictor of physical discomfort. However, a history of penetrative CSA was a significant predictor of psychological discomfort (P = .02).
The prevalence of CSA in this sample was similar to the general population literature on this topic. In this small sample, a past history of CSA did not contribute significantly to the physical discomforts associated with sexual intimacy after breast cancer; however, our findings suggest that a past history of penetrative CSA is associated with increased psychological discomfort, and may warrant additional examination in future research.
乳腺癌幸存者童年性虐待（CSA）史及其与癌症后性功能的关系鲜为人知。作为一项关于乳腺癌幸存者性与亲密关系的大型调查研究的一部分，我们对一部分参与者进行了面对面访谈。
加利福尼亚州洛杉矶市和华盛顿特区的147名女性完成了一项结构化访谈，内容涉及性社会化和性虐待史。由经过培训的女性访谈员进行访谈。采用描述性统计和回归分析来研究CSA的患病率及其对性健康和性功能的潜在影响。
三分之一的女性报告至少有一次CSA事件。在经历过CSA的女性中，71%报告有单次事件，22%报告有性接触的插入形式。在对性和身体形象的生理及心理方面进行的多变量回归分析中，CSA不是身体不适的显著预测因素。然而，插入性CSA史是心理不适的显著预测因素（P = 0.02）。
该样本中CSA的患病率与关于该主题的一般人群文献相似。在这个小样本中，既往CSA史对乳腺癌后与性亲密相关的身体不适没有显著影响；然而，我们的研究结果表明，既往插入性CSA史与心理不适增加有关，可能值得在未来研究中进一步探讨。
