Intimate Partner Violence Victimization, Cancer Screening and Chronic Disease Risk

More than 1 in 4 women and 1 in 10 men have experienced sexual violence, physical violence, or stalking by an intimate partner in their lifetimes. Intimate partner violence (IPV) victims often experience significant and persistent mental and physical health problems that is a direct consequence of violence. IPV is associated with increased risk for injury and serious health outcomes, including cancer, cardiovascular disease, gastrointestinal disorders, chronic pain, and a host of other conditions that appear to reflect the effects of chronic stress and other mechanisms on the body’s systems. IPV victims have higher rates of health behaviors that increase risk for poor health, including using tobacco and other harmful substances and unhealthy diet. We sought to understand the impact of IPV and risk for chronic health conditions, such as cancer, by examining the role of cancer screening, which detects cancer early, when it is easier to treat.

We used Behavioral Risk Factor Surveillance System (BRFSS) data from 8 states and one territory (U.S. Virgin Islands) that administered the optional IPV module to examine the association between self-reported IPV victimization and compliance with cancer screening recommendations for breast and cervical cancer for women and for colorectal cancer for men and women. The analysis included 38,317 participants; 23.6% of females and 11.3% of males reported lifetime IPV victimization (weighted prevalence). Male and female victims reported higher rates of current tobacco use and binge drinking and less social and emotional support and life satisfaction than non-victims. Male and female victims had more days in self-reported fair or poor health, but had similar rates of overweight/obesity. Fewer male and female victims had health insurance, a personal doctor or healthcare provider, a flu shot in the last year, and received regular checkups within the past 2 years. After adjusting for significant demographic, health status, and risk behaviors, multivariable logistic regression results indicated that IPV victimization was associated with lower mammography screening for women ages ≥ 40 (72% for victims vs. 76% for non-victims, p = 0.02). For cervical cancer screening among women, there was a significant interaction with age and IPV victimization; more non-victims ages 55-64 were up-to-date with screening. There were no significant differences in cervical cancer screening between victims and non-victims for all other ages. IPV victimization was not significantly associated with colorectal cancer screening among either men or women. These data suggest that IPV victimization may be associated with risk behaviors for chronic diseases and lower healthcare use, including breast cancer screening.