1 Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia .
2 Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention , Atlanta, Georgia .
J Womens Health (Larchmt). 2018 May;27(5):607-614. doi: 10.1089/jwh.2017.6402. Epub 2017 Sep 7.
Intimate partner violence (IPV) victims often experience substantial and persistent mental and physical health problems, including increased risk for chronic disease and barriers to healthcare access. This study investigated the association between IPV and cancer screening.
Behavioral Risk Factor Surveillance System data from the eight states and one U.S. territory that administered the optional IPV module in 2006 were analyzed to examine demographic characteristics, health behaviors, health status, healthcare coverage, use of health services, and cancer screening among men and women who reported IPV victimization compared with those among men and women who did not. IPV victimization included physical violence, threats, and sexual violence.
In the nine jurisdictions that administered the IPV module, 23.6% of women and 11.3% of men experienced IPV. Fewer women and men reporting IPV victimization had health insurance, a personal doctor or healthcare provider, or regular checkups within the past 2 years than nonvictims. More male and female IPV victims were current tobacco users and engaged in binge drinking in the past month. IPV victims of both sexes also had poorer health status, lower life satisfaction, less social and emotional support, and more days with poor physical and mental health in the past month than nonvictims. IPV victimization was associated with lower rates of mammography and colorectal cancer screening but not cervical cancer screening in women and was not associated with colorectal cancer screening in men. In multivariable logistic regression results presented as adjusted proportions controlling for demographics, health status, and healthcare access, only the association with mammography screening remained significant, and the magnitude of this association was modest.
There were consistent differences between IPV victims and nonvictims in nearly every measure of healthcare access, health status, and preventive service use. Much of this association seems explained by population characteristics associated with both IPV and lower use of preventive service use, including differences in demographic characteristics, health status, and healthcare access. Healthcare providers could take steps to identify populations at high risk for lack of access or use of preventive services and IPV victimization.
亲密伴侣暴力(IPV)受害者经常经历严重且持续的身心健康问题,包括患慢性病的风险增加和获得医疗保健的障碍。本研究调查了 IPV 与癌症筛查之间的关联。
对 2006 年 8 个州和一个美国领土进行的行为风险因素监测系统数据进行了分析,以检查报告 IPV 受害的男性和女性与未报告 IPV 受害的男性和女性在人口统计学特征、健康行为、健康状况、医疗保健覆盖范围、使用卫生服务以及癌症筛查方面的差异。IPV 受害包括身体暴力、威胁和性暴力。
在实施 IPV 模块的九个司法管辖区中,23.6%的女性和 11.3%的男性经历过 IPV。与非受害者相比,报告 IPV 受害的女性和男性拥有健康保险、私人医生或医疗保健提供者、或在过去 2 年内定期体检的比例较低。更多的男性和女性 IPV 受害者是当前的烟草使用者,并在过去一个月中暴饮。与非受害者相比,两性的 IPV 受害者在过去一个月中身体和精神健康状况较差、生活满意度较低、社会和情感支持较少、身体和精神健康较差的天数也较多。IPV 受害与女性的乳房 X 光检查和结直肠癌筛查率较低相关,但与宫颈癌筛查无关,与男性的结直肠癌筛查无关。在多变量逻辑回归结果中,以控制人口统计学、健康状况和医疗保健获得情况的调整比例表示,只有与乳房 X 光检查筛查的关联仍然显著,而且这种关联的程度适中。
在几乎每一项医疗保健获取、健康状况和预防服务使用的衡量标准上,IPV 受害者和非受害者之间都存在一致的差异。这种关联的大部分似乎可以用与 IPV 和预防性服务使用率较低相关的人口特征来解释,包括人口统计学特征、健康状况和医疗保健获取方面的差异。医疗保健提供者可以采取措施,确定缺乏获取或使用预防服务和 IPV 受害风险较高的人群。