Intimate Partner Violence and Cancer Screening among Urban Minority Women
ABSTRACT To evaluate the association of intimate partner violence (IPV) with breast and cervical cancer screening rates.
We conducted retrospective chart audits of 382 adult women at 4 urban family medicine practices. Inclusion criteria were not being pregnant, no cancer history, and having a partner. Victims were defined as those who screened positive on at least one of 2 brief IPV screening tools: the HITS (Hurt, Insult, Threat, Scream) tool or Women Abuse Screening Tool (short). Logistic regression models were used to examine whether nonvictims, victims of emotional abuse, and victims of physical and/or sexual abuse were up to date for mammograms and Papanicolaou smears.
Prevalence of IPV was 16.5%. Compared with victims of emotional abuse only, victims of physical and/or sexual abuse aged 40 to 74 were associated with 87% decreased odds of being up to date on Papanicolaou smears (odds ratio, 0.13; 95% CI, 0.02-0.86) and 84% decreased odds of being up to date in mammography (odds ratio, 0.16; 95% CI, 0.03-0.99). There was no difference in Papanicolaou smear rates among female victims and nonvictims younger than 40.
Because of the high prevalence of IPV, screening is essential among all women. Clinicians should ensure that victims of physical and/or sexual abuse are screened for cervical cancer and breast cancer, particularly women aged 40 or older. Cancer screening promotion programs are needed for victims of abuse.
Journal of pain and symptom management 08/2013; 47(4). DOI:10.1016/j.jpainsymman.2013.05.018 · 2.74 Impact Factor
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ABSTRACT: The purpose of this paper is to critically examine the literature and present a comprehensive model of three pathways through which IPV increases the risk for cervical cancer. The first pathway is increased exposure to cervical cancer risk factors among IPV victims, including smoking, psychosocial stress, risky sexual behaviors, and sexually transmitted infections (STDs/STIs), particularly human papillomavirus infection. The second pathway is poor compliance with cervical cancer screening. The third pathway is delay/discontinuation in treatment for cervical dysplasia and neoplasia. Control imposed by the abusive partner, competing life priorities, and limited access to financial/support resources restrict a woman’s ability to seek cancer services. Higher rates, severity, and duration of IPV among low-income, Black, and Hispanic women may explain the pervasive cervical cancer disparities.Journal of Family Violence 05/2015; DOI:10.1007/s10896-015-9733-7 · 1.17 Impact Factor
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ABSTRACT: Millions of women in the United States experience physical abuse because of intimate partner violence (IPV) that results in injuries, social and family dysfunction, mental health disorders, chronic pain and illness, and death. Cancer causes a quarter of the deaths of women in the United States. When IPV and a cancer diagnosis intersect, a special population of women with unique needs is created. The purpose of the current study was to determine the rates of IPV and the types of cancer reported by women seeking services for IPV. Safety, community agency use, severity of violence, danger, psychological distress, post-traumatic stress disorder, self-efficacy, social support, pain, and marginality also were assessed. Three hundred abused women were interviewed in person to determine their health, safety, and functioning. Of the 300 women, eight reported receiving a cancer diagnosis, and most of those women had cervical cancer. The prevalence of cervical cancer reported by abused women was 10 times higher than the general population. Higher danger scores and risk for revictimization were reported. Increased awareness of the potential connection between IPV and cancer is needed, and evidence-based strategies that promote IPV screening in the oncology setting should be developed.Clinical Journal of Oncology Nursing 02/2014; 18(1):65-73. DOI:10.1188/14.CJON.65-73