Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China; Department of Mathematics and Statistics, Mzuzu University, Luwinga, Mzuzu, Malawi.
Child Abuse Negl. 2021 Jul;117:105088. doi: 10.1016/j.chiabu.2021.105088. Epub 2021 May 8.
Research findings on the relationship between adverse childhood experiences (ACEs) and the risk of cancer were inconsistent.
The purpose of this study was to perform a quantitative synthesis of the preceding research findings.
System review and meta-analysis.
Electronic database of PubMed, Embase, Web of Science and Cochrane Library were systematically searched to identify relevant observational studies published not later than September 9, 2020. Specifically, original articles that reported the risk of cancer in adult populations that experienced ACEs before the age of 18 were selected. All pooled odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using a random-effects model. Publication bias was examined using funnel plots, and sensitivity analysis was used to explore the stability of the pooled results.
A total of 18 studies involving 406,210 participants were included in this review. Individuals with 2 or 3 kinds of ACEs (OR = 1.35, 95%CI:1.12,1.62) or at least 4 ACEs (OR = 2.17, 95%CI: 1.76,2.68) were at increased risk of cancer when compared with individuals with no ACEs. Of the different types of ACEs examined, physical abuse (OR = 1.23, 95%CI:1.05,1.43), sexual abuse (OR = 1.26, 95%CI:1.02,1.56), exposure to intimate partner violence (OR = 1.26, 95%CI:1.12,1.41) and financial difficulties in the family (OR = 1.16, 95%CI:1.00,1.33) were associated with the risk of any cancer.
These findings suggest that multiple ACEs may be a risk factor for cancer development. Therefore, prevention of ACEs and interventions for supporting those affected by ACEs are necessary.
关于不良童年经历（ACEs）与癌症风险之间关系的研究结果不一致。
本研究旨在对先前的研究结果进行定量综合。
系统评价和荟萃分析。
系统检索 PubMed、Embase、Web of Science 和 Cochrane Library 电子数据库，以确定截至 2020 年 9 月 9 日发表的相关观察性研究。具体而言，选择了报告 18 岁以下经历 ACE 的成年人群体癌症风险的原始文章。使用随机效应模型计算所有汇总优势比（OR）和 95%置信区间（CI）。使用漏斗图检查发表偏倚，并进行敏感性分析以探索汇总结果的稳定性。
本综述共纳入了 18 项研究，涉及 406210 名参与者。与没有 ACE 的个体相比，经历 2 种或 3 种 ACE（OR=1.35，95%CI：1.12，1.62）或至少 4 种 ACE（OR=2.17，95%CI：1.76，2.68）的个体患癌症的风险增加。在所检查的不同 ACE 类型中，身体虐待（OR=1.23，95%CI：1.05，1.43）、性虐待（OR=1.26，95%CI：1.02，1.56）、亲密伴侣暴力暴露（OR=1.26，95%CI：1.12，1.41）和家庭经济困难（OR=1.16，95%CI：1.00，1.33）与癌症风险相关。
这些发现表明，多种 ACE 可能是癌症发展的危险因素。因此，预防 ACE 和为受 ACE 影响的人提供支持是必要的。
