Abstract

Adverse childhood experiences and cancer in adulthood

Anna Mavromanoli1, Claudia Sikorski2, Danial Behzad3, Karishma Manji4 and Catherine Kreatsoulas5
(1)Johannes Gutenberg University, Mainz, Germany, (2)McMaster University, Hamilton, ON, Canada, (3)Brock University, St. Catharines, ON, Canada, (4)University of Toronto, Toronto, ON, Canada, (5)Harvard T.H. Chan School of Public Health, Boston, MA

APHA 2024 Annual Meeting and Expo

Background: Cancer is a leading cause of morbidity and mortality. Stressful events that occur during childhood/adolescence can trigger an increased inflammatory response, associated with chronic diseases such as cancer. Early life stressors of the psychosocial environment such as adverse childhood experiences (ACEs) have been inadequately studied as a primordial risk factor of cancer.

Objectives: To systematically analyze and determine: 1) the prevalence of ACEs and 2) the pooled adjusted estimate of ACEs among individuals with cancer.

Methods: This systematic review collated studies from peer-reviewed and grey literature up to Mar 16, 2023 (registered on PROSPERO CRD42024509874). Observational studies with a comparator group that assessed ACEs ≤18 years, and diagnosed cancer ≥21 years of age were analyzed. Pooled adjusted odds ratios (ORs) were estimated using a multilevel linear random-effects model.

Results: Our search yielded 39,658 articles, of which 23 studies were eligible for meta-analysis. Of the 356,519 participants, 186,325 participants (52.3%) reported at least one ACE, of which 11.7% were diagnosed with cancer (21,751/186,325). The meta-analysis revealed that the presence of ACE on cancer increased in a dose-response, ranging from 1 ACE (OR=1.03, 95% CI: 0.83-1.27) to 4+ACEs OR=1.30, 95% CI:1.05-1.62).


Conclusion: We demonstrate that ACEs are an important primordial risk factor for cancer. Addressing childhood traumas within a public health framework is an opportunity for improved cancer prevention.

Biostatistics, economics Chronic disease management and prevention Clinical medicine applied in public health Epidemiology Social and behavioral sciences