Physical, Sexual and Emotional Child abuse and Cancer: Not Just Another Adverse Childhood Experience

Background: A burgeoning body of literature has linked experiences of child abuse to increased risk of cancer in adulthood. The goal of the present study was to examine if each child abuse subtype (i.e. physical, sexual and emotional) impacted odds of cancer, while accounting for the other abuse types and other adverse childhood experiences (ACEs).

Methods: Data from the 2011 BRFSS (N=120,586) were used. The sample included adults, age 18 and over, from nine different states. Dichotomous measures of physical, and emotional abuse, indicated whether or not a respondent experienced that type of abuse as a child. Similarly, dichotomous measures of ACEs captured experiences that included having parents that were separated or living in a home with an adult drug user. A logistic regression model predicting a lifetime diagnosis of cancer was run. Independent variables included all abuse subtypes, ACEs, age, gender, race and state of residence.

Results: After controlling for ACEs, age, gender, race and state of residence, physical (AOR=1.23; 95% CI: 1.09-1.40), sexual (AOR=1.37; 95% CI: 1.23-1.53) and emotional abuse (AOR=1.10; 95% CI: 1.00-1.21) were independently associated with increased odds of cancer. Among ACEs, only living with a mentally ill adult (AOR=1.17; 95% CI: 1.02-1.33) and living with someone who was jailed (AOR=1.25; 95% CI: 1.00-1.57) increased odds of cancer.

Discussion: All childhood abuse subtypes appear to increase cancer risk. As such, research should avoid treating abuse and ACEs as interchangeable experiences. Current cancer prevention efforts may benefit by targeting child abuse survivors.