Background: Adverse childhood experiences (ACEs) are prevalent for many women, and have been proven to lead to an increase in chronic diseases including cancer. While the mechanism behind this is not completely understood, the literature suggests that it may be partially due to decreased utilization of cancer screening. Due to the widespread nature of cervical cancer, this literature review seeks to investigate the relationship between ACEs and cervical cancer screening.
Methods: An exhaustive literature search of MEDLINE-PubMed, Web of Science, Public Health Database, and PyschINFO was performed. The keywords used in the search include: adverse childhood experiences, childhood trauma, cervical cancer screening, Pap test, Papanicolaou test, and cancer screening. Each of the selected studies were evaluated via the GRADE system.
Results: Out of the 46 articles that were found in the literature search, only 4 met inclusion criteria for this literature review. Two of the studies were cross sectional surveys, 1 was a prospective cohort study, and the other was a case-control study. Childhood physical and sexual abuse were most commonly found to be correlated with a decrease in correct utilization of cervical cancer testing. Domestic violence in the home was found in 1 study to be correlated with a higher likelihood of ever obtaining a Pap smear, but there was not a statistically significant relationship with correct utilization of the screening test.
Conclusion: Decreased utilization of cervical cancer screening is associated with a history of childhood physical and sexual abuse, as well as several other ACEs that were identified by researchers. It is important for providers to not only continue researching this relationship, but to also develop interventions to help identify patients with a history of ACEs that have not obtained cancer screening.
Keywords: Adverse childhood experiences, childhood trauma, childhood physical abuse, childhood sexual abuse, Pap smear, Pap test, Papanicolaou test
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