The Association Between Adverse Childhood Experiences and Risk of Cancer in Adulthood: A Systematic Review of the Literature.
The Association Between Adverse Childhood Experiences and Risk of Cancer in Adulthood: A Systematic Review of the Literature.
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DOI：
10.1542/peds.2015-4268l
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发表时间：
2016-11
期刊：
影响因子：
8
通讯作者：
Trivers KF
中科院分区：
文献类型：
--
作者：
Holman DM;Ports KA;Buchanan ND;Hawkins NA;Merrick MT;Metzler M;Trivers KF
不良童年经历 (ACE) 会影响整个生命过程的健康和福祉。本系统综述总结了有关 ACE 与成年癌症风险之间关联的文献。我们检索了 PubMed，以确定 2015 年 5 月 31 日或之前发表的相关出版物。我们纳入了量化 ACE 与成人癌症发病率之间关联的原始研究。病例报告和评论被排除在外。两名评审员独立地从纳入的研究中提取和总结关键信息（例如，ACE 类型、癌症类型、风险估计）并解决所有差异。审查中纳入了十二项研究。在计算 ACE 总分的研究中，观察到这些分数与成年期患癌症风险增加之间存在显着关联。在所检查的不同类型的 ACE 中，分别有 3 项和 2 项研究表明身体和心理虐待受害与任何癌症的风险相关。两项研究还报告了与性虐待受害有关的显着关联（1 项与宫颈癌有关，1 项与任何癌症有关）。然而，另外两项研究报告称，儿童期性虐待或身体虐待与宫颈癌或乳腺癌的发病率之间没有显着关联。由于研究之间存在异质性，我们无法计算汇总效果估计。这些发现表明，各种形式的童年逆境可能会增加一个人患癌症的风险。需要进一步的研究来了解驱动这种关系的机制，并找到机会来预防和减轻早期逆境对长期健康的有害影响。
Adverse childhood experiences (ACEs) can affect health and well-being across the life course. This systematic review summarizes the literature on associations between ACEs and risk of cancer in adulthood. We searched PubMed to identify relevant publications published on or before May 31, 2015. We included original research quantifying the association between ACEs and adult cancer incidence. Case reports and reviews were excluded. Two reviewers independently abstracted and summarized key information (eg, ACE type, cancer type, risk estimates) from included studies and resolved all discrepancies. Twelve studies were included in the review. In studies in which ACE summary scores were calculated, significant associations were observed between the scores and an increased risk of cancer in adulthood. Of the different types of ACEs examined, physical and psychological abuse victimization were associated with risk of any cancer in 3 and 2 studies, respectively. Two studies also reported significant associations with regard to sexual abuse victimization (1 for cervical cancer and 1 for any cancer). However, 2 other studies reported no significant associations between childhood sexual or physical abuse and incidence of cervical or breast cancer. Because of heterogeneity across studies, we were unable to compute a summary effect estimate. These findings suggest that childhood adversity in various forms may increase a person’s cancer risk. Further research is needed to understand the mechanisms driving this relationship and to identify opportunities to prevent and mitigate the deleterious effects of early adversity on long-term health.