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, 138 (Suppl 1), S81-S91

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

Dawn M Holman et al. Pediatrics.


Context: Adverse childhood experiences (ACEs) can affect health and well-being across the life course.

Objective: This systematic review summarizes the literature on associations between ACEs and risk of cancer in adulthood.

Data sources: We searched PubMed to identify relevant publications published on or before May 31, 2015.

Study selection: We included original research quantifying the association between ACEs and adult cancer incidence. Case reports and reviews were excluded.

Data abstraction: Two reviewers independently abstracted and summarized key information (eg, ACE type, cancer type, risk estimates) from included studies and resolved all discrepancies.

Results: 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.

Limitations: Because of heterogeneity across studies, we were unable to compute a summary effect estimate.

Conclusions: 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.

Conflict of interest statement

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

POTENTIAL CONFLICT OF INTEREST: The authors indicated they have no potential conflicts of interest to disclose.


Flowchart of article selection.
Types of ACEs and the number of studies in which they were included (N = 12 studies).

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