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男性和女性中的性侵犯与癌症筛查。

Sexual Assault and Cancer Screening Among Men and Women.

机构信息

Stony Brook University, NY, USA.

University of Virginia, Charlottesville, USA.

出版信息

J Interpers Violence. 2021 Jun;36(11-12):NP6243-NP6259. doi: 10.1177/0886260518812797. Epub 2018 Nov 26.

Abstract

Emerging research has shown that experiences of sexual violence are associated with cancer screening behaviors. However, to date, little attention has been given to the impact of sexual assault on cancer screening behaviors, particularly among men. To address this, we used data from the 2014 Kansas Behavioral Risk Factor Surveillance System. This survey is conducted annually via telephone. Logistic regressions were used to calculate odds of ever engaging (i.e., lifetime) in specific screening behaviors (clinical breast exam [CBE], mammogram, Pap test, colonoscopy/sigmoidoscopy, fecal occult blood test and prostate-specific antigen [PSA] test) and current compliance with cancer screening recommendations (CBE, mammogram, Pap test, colorectal cancer screening, and PSA test), with lifetime sexual assault as the independent variables. Colorectal cancer screening models were stratified by gender. All models adjusted for confounders. Sexual assault was associated with lower odds of ever receiving a PSA test and, for women, higher odds of ever receiving a colonoscopy or sigmoidoscopy. Sexual assault was associated with lower odds of current compliance with CBE, mammogram, Pap test, and PSA test screening recommendations. A history of sexual assault was associated with lower odds of current compliance with cancer screening procedures, with the notable exception of colorectal cancer screening. Less consistent patterns were seen for lifetime screenings. Results suggest that alternatives to currently recommended procedures (like self-collection of HPV [human papilloma virus] DNA) or modified screening procedures may be a promising route to increase current compliance with cancer screening among a population that may avoid these procedures due to pain or fear of retraumatization.

摘要

新兴研究表明,性暴力经历与癌症筛查行为有关。然而,迄今为止,人们对性侵犯对癌症筛查行为的影响关注甚少,尤其是在男性中。为了解决这个问题,我们使用了 2014 年堪萨斯州行为风险因素监测系统的数据。这项调查每年通过电话进行。使用逻辑回归计算了特定筛查行为(临床乳房检查[CBE]、乳房 X 光检查、巴氏试验、结肠镜检查/乙状结肠镜检查、粪便潜血试验和前列腺特异性抗原[PSA]试验)和癌症筛查建议的当前依从性(CBE、乳房 X 光检查、巴氏试验、结直肠癌筛查和 PSA 试验)的终身参与(即终生)的可能性,其中性侵犯是独立变量。对性别进行了分层的结直肠癌筛查模型。所有模型都调整了混杂因素。性侵犯与接受 PSA 测试的可能性降低有关,而对于女性,接受结肠镜或乙状结肠镜检查的可能性更高。性侵犯与 CBE、乳房 X 光检查、巴氏试验和 PSA 试验筛查建议的当前依从性降低有关。性侵犯史与当前癌症筛查程序的依从性降低有关,结直肠癌筛查是一个显著的例外。终身筛查方面出现了不太一致的模式。研究结果表明,目前推荐的程序的替代方法(如自行收集 HPV[人乳头瘤病毒]DNA)或修改后的筛查程序可能是提高可能因疼痛或担心再次创伤而避免这些程序的人群对癌症筛查的当前依从性的一种有前途的途径。

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