Coker Ann L, Hopenhayn Claudia, DeSimone Christopher P, Bush Heather M, Crofford Leslie
Department of Obstetrics and Gynecology, University of Kentucky, Lexington, KY 40536-0293, USA.
J Womens Health (Larchmt). 2009 Aug;18(8):1179-85. doi: 10.1089/jwh.2008.1048.
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.
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).
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).
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.
越来越多的文献表明,针对妇女的暴力行为(VAW),尤其是性暴力,可能会增加感染性传播感染(STI)的风险,因此可能与宫颈癌的发生有关。本横断面分析的目的是确定经历过暴力行为的女性浸润性宫颈癌的患病率是否更高。
样本纳入了加入肯塔基州妇女健康登记处(2006 - 2007年)并完成问卷调查的18 - 88岁女性。采用多变量逻辑回归分析来调整混杂因素(如年龄、教育程度、当前婚姻状况、终生非法药物使用情况以及吸烟包年数)的比值比(OR)。
在4732名暴力、宫颈癌或人口统计学因素无缺失数据的参与者中,103人(2.1%)报告曾患宫颈癌。在调整人口统计学因素、吸烟和非法药物使用情况后,经历VAW与浸润性宫颈癌患病率增加相关(调整后的OR [aOR] = 2.6,95%可信区间[CI] = 1.7 - 3.9)。当观察三种特定类型的VAW时,这种关联仍然显著:亲密伴侣暴力(IPV)(aOR = 2.7,95% CI = 1.8 - 4.0)、成年期遭受强迫性行为(aOR = 2.6,95% CI = 1.6 - 4.3)以及儿童期遭受性虐待(aOR = 2.4,95% CI = 1.4 - 4.0)。
相对于从未经历过VAW的女性,经历过所有三种类型VAW的女性宫颈癌发病率最高。由于VAW很常见且对妇科健康有影响,在医疗保健环境中询问VAW情况并利用这些信息提供个性化医疗保健可能会改善女性的健康状况。