社区医学与健康教育

抽象的

Association between Abusive and Non-abusive Adverse Childhood Experiences and Diagnosis of Cancer in Wisconsin, USA

Monique J Brown and Steven A Cohen

Background: Adverse childhood experiences (ACEs) have been found to be associated with cancer diagnosis. Aim: The main aim of this study was to determine the extent to which ACEs (abusive and nonabusive) are associated with diagnosis of all cancers in Wisconsin, USA. Methods: Data for this cross-sectional study were obtained from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) survey, which was administered from January to December. The BRFSS is the largest ongoing telephone health survey, conducted in all US states, the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands. The BRFSS provides data on a variety of health behaviors and outcomes among the non-institutionalized US population, 18 years and older. Wisconsin was the only state that asked questions on adverse childhood experiences and cancer diagnosis and the final sample size was 4,163. Results: Respondents who reported ≥ 2 ACEs were 53% more likely to have a diagnosis of cancer compared to respondents who did not report ACEs (adjusted OR: 1.53; 95% CI: 1.09-2.13, p=0.0127). Respondents who reported 1 and ≥ 2 nonabusive ACEs were 49% and 53% more likely, respectively, to have a diagnosis of cancer compared to respondents who did not report nonabusive ACEs (adjusted OR: 1.49; 95% CI: 1.07-2.09, p=0.0198; adjusted OR: 1.53; 95% CI: 1.07-2.19, p=0.0201). Conclusion: Exposure to ACEs overall and, specifically, non-abusive ACEs, was found to be associated with diagnosis of cancer. This association could be due to stressors during childhood influencing health behaviors, which may contribute to tumor growth, and/or stressors resulting in epigenetic modifications, which may result in tumor growth, which may lead to cancer.