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Violence against Women Raises Risk of Cervical Cancer

To cite this article:
Ann L. Coker, Claudia Hopenhayn, Christopher P. DeSimone, Heather M. Bush, and Leslie Crofford. Journal of Women's Health. August 2009, 18(8): 1179-1185. doi:10.1089/jwh.2008.1048.

Published in Volume: 18 Issue 8: August 11, 2009
Online Ahead of Print: July 24, 2009

Author information

Ann L. Coker, Ph.D.,1 Claudia Hopenhayn, Ph.D.,2 Christopher P. DeSimone, M.D.,1 Heather M. Bush, Ph.D.,2 and Leslie Crofford, M.D.3
1Department of Obstetrics and Gynecology, University of Kentucky, Lexington, Kentucky.
2College of Public Health, University of Kentucky, Lexington, Kentucky.
3Department of Internal Medicine, University of Kentucky, Lexington, Kentucky.
Address correspondence to:

Ann L. Coker, Ph.D.

Department of Obstetrics and Gynecology

Center for Research on Violence against Women

University of Kentucky
800 Rose Street, C-371

Lexington, KY 40536-0293

E-mail:

ABSTRACT

Abstract

Background: An emerging literature suggests that violence against women (VAW), particularly sexual violence, may increase the risk of acquiring a sexually transmitted infection (STI) and, therefore, may be associated with cervical cancer development. The purpose of this cross-sectional analysis was to determine if women who had experienced violence had higher prevalence rates of invasive cervical cancer.

Methods: Women aged 18–88 who joined the Kentucky Women's Health Registry (2006–2007) and completed a questionnaire were included in the sample. Multivariate logistic regression analyses were used to adjust odds ratio (OR) for confounders (e.g., age, education, current marital status, lifetime illegal drug use, and pack-years of cigarette smoking).

Results: Of 4732 participants with no missing data on violence, cervical cancer, or demographic factors, 103 (2.1%) reported ever having cervical cancer. Adjusting for demographic factors, smoking, and illegal drug use, experiencing VAW was associated with an increased prevalence of invasive cervical cancer (adjusted OR [aOR] = 2.6, 95% CI = 1.7-3.9). This association remained significant when looking at three specific types of VAW: intimate partner violence (IPV) (aOR = 2.7, 95% CI = 1.8-4.0), adult exposure to forced sex (aOR = 2.6, 95% CI = 1.6-4.3), and child exposure to sexual abuse (aOR = 2.4, 95% CI = 1.4-4.0).

Conclusions: Rates of cervical cancer were highest for those experiencing all three types of VAW relative to those never experiencing VAW. Because VAW is common and has gynecological health effects, asking about VAW in healthcare settings and using this information to provide tailored healthcare may improve women's health outcomes.

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