Statement of Purpose Examine the impact of intimate partner violence (IPV) on receipt of cancer treatment and surveillance.
Methods Longitudinal data were collected for breast and cervical cancer survivors from 2009–2017 at Parkland Health and Hospital System. Data were extracted and merged from two sources. First, electronic health records were used to assess survivors’ cancer treatment modalities (i.e. surgery, chemotherapy, radiation, hormone replacement therapy) and concordance with National Comprehensive Cancer Network (NCCN) surveillance guidelines. Second, survivors were invited to participate in a phone survey that included 9-item validated screened for IPV. Regression models were used to evaluate the impact of IPV history on cancer treatment and NCCN guidelines.
Results/Findings 54% of survivors were a victim of IPV in their lifetime and 10% of victims experienced victimization during active cancer treatment. IPV victims were more likely to get a single agent chemotherapy compared to non-victims (x2=6.68, p-value< 0.02) and less likely get hormone replacement therapy (x2=12.55; p-value<0.001). There was no significant relationship between IPV history and concordance with NCCN guidelines. After adjusting for key confounders, the odds of hormone replacement therapy was 0.34 times less likely among patients with a history of IPV compared to patients without a history of victimization (OR=0.34; 95% CI: 0.19, 0.60).
Conclusion Largely, cancer treatment and surveillance do not differ for women with a history of IPV. This suggests that, for this limited time of active treatment, access to the healthcare system is not restricted by abusive partners. Healthcare systems can leverage this valuable window to help the victim access social services.
Significance IPV screening is recommended as standard practice in healthcare because it improves patient health and safety. New evidence suggests screening is especially important in oncology clinics, where victims are more likely to be diagnosed with cancer and less likely to survive from cancer.
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