Adult Cancer Risk Behaviors Associated with Adverse Childhood Experiences in a Low Income Population in the Southeastern United States

J Health Care Poor Underserved. 2016 Feb;27(1):68-83. doi: 10.1353/hpu.2016.0027.


Objectives: Adverse childhood experiences (ACE) can affect health in adulthood. We investigate the relationship between childhood experiences and adult cancer risk and screening behaviors in a racially diverse, low income population.

Methods: Nearly 22,000 adults 40 years and older in the Southern Community Cohort Study were administered the ACE questionnaire. We estimated odds ratios (OR) for the prevalence of smoking, alcohol consumption, BMI and five cancer screening methods in relation to the ACE score.

Results: Over half reported at least one ACE, with percentages higher for women (61%) than men (53%). Higher ACE scores were related to increased prevalence of smoking (ORs 1.25 (1.05-1.50) to 2.33 (1.96-2.77). Little association was seen between rising ACE score and alcohol consumption or BMI, except for a modest trend in morbid obesity (BMI ≥ 40 kg/m2). Mammography and cervical cancer screening decreased with rising ACE scores, but no trends were seen with prostate or colorectal cancer screening.

Conclusions: Adverse childhood experiences are strong predictors of adult cancer risk behaviors, particularly increased likelihood of smoking, and among women, lower mammography and Pap screening rates.