Different cancer risks for women and men with adverse childhood experiences, study finds

WASHINGTON, DC (November 16, 2017)— People who experience abuse or other adverse events in childhood face higher lifetime risks for several diseases, including cancer, but those risks may not be evenly distributed. When researchers examined eight kinds of adverse childhood experiences, they found seven of those experiences to be associated with higher cancer risks in women, whereas only one – emotional abuse – was linked to greater cancer risk in men. They report their findings in the Editor’s Choice selection of the latest issue of the journal Women’s Health Issues, “Gender Differences in the Association between Adverse Childhood Experiences and Cancer.”

Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based in the Department of Health Policy and Management at Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.

Study author Héctor E. Alcalá, now at Stony Brook University, and his UCLA colleagues (Janet Tomiyama and Ondine von Ehrenstein) used data on more than 100,000 U.S. adults from 10 states who responded to the 2011 Behavioral Risk Factor Surveillance System survey. The authors examined eight kinds of adverse childhood experiences (ACEs): physical abuse, emotional abuse, sexual abuse, living with someone who was mentally ill, living with a problem drinker, living with a drug user, living in a household where adults treated each other violently, and having parents who were separated or divorced. 

In an analysis of the entire sample that adjusted for age, race, educational attainment, smoking, and state of residence, the authors found seven of the eight ACES — all of those examined except for having separated or divorced parents — to be associated with a greater risk of ever having received a diagnosis of any kind of cancer other than skin cancer. However, when they stratified the analyses by gender, they found the same seven ACEs (physical abuse, sexual abuse, emotional abuse, living with someone who was mentally ill, living with a problem drinker, living with a drug user, and living in a household where adults treated each other violently) to be associated with greater odds of a cancer diagnosis in women, while only emotional abuse was associated with elevated cancer risk in men.

In considering reasons for the gender disparity they found, Alcalá and his co-authors note that women experience many ACEs at higher rates than men, and sexual abuse can expose them to cancer-causing viruses such as HPV. They call for more research to investigate why ACEs seem to be more harmful for women than men, and suggest that mitigation efforts consider gender disparities. For instance, they note that women with histories of childhood sexual abuse may avoid cervical cancer screenings, and recommend making less-invasive options available to this population.  

The study, “Gender Differences in the Association between Adverse Childhood Experiences and Cancer,” has been published in the November/December issue of Women’s Health Issues.