The association of childhood experiences of abuse on timely cervical cancer screening utilization among women in the United States

Abstract

Objective: Cervical cancer remains a significant public health concern, particularly among vulnerable populations. This study examines the association between Adverse Childhood Experiences (ACEs) and timely Pap test utilization for cervical cancer screening among women aged 21-65 years, with a focus on the association of abuse.

Methods: This study utilized the 2020 Behavioral Risk Factor Surveillance System (BRFSS) that included 41,111 women aged 21-65 years from 29 states. Using descriptive analysis and multivariable logistic regression, we conducted exploratory analyses to assess the association between experiences of abuse and timely Pap test utilization and to examine if household challenges moderate this association.

Results: Women who did not experience abuse had higher odds of receiving a timely Pap test compared to those with a history of abuse (aOR = 1.29, 95 % CI: 1.08-1.54). While household challenges were not significantly associated with timely screenings (aOR = 0.84, 95 % CI: 0.71-1.01), women without household challenges and abuse had significantly higher odds of receiving timely Pap tests (aOR = 1.66, 95 % CI: 1.27-2.17). Non-Hispanic Black women, married women, women with higher education, women who were employed, and women who had health insurance showed higher odds of timely Pap test utilization.

Conclusions: The study highlights the association between ACEs and preventive health behaviors. These findings emphasize the need for trauma-informed care interventions to address these disparities. Policy recommendations include expanding and enhancing access to cervical cancer screening for women with ACEs.

Keywords: Abuse; Adverse childhood experiences (ACEs); Cervical cancer; Pap test utilization; Screening.