Evidence map›Paper›PMID 38700620›Full record

ArticleJournal of cancer survivorship : research and practice2025

Association between adverse childhood experiences and health related quality of life in adult cancer survivors in the United States.

Emily C Merkel, Daron M Vandeleur, Xin Cheng, Alyson J Littman, K Scott Baker

Abstract read
In one paragraph

Article in Journal of cancer survivorship : research and practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Impact of adverse childhood experiences on health-related quality of life in Australian women with endometriosis: a population-based cohort study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026
    Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Emily C MerkelDepartment of Epidemiology, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA. emily.merkel@seattlechildrens.org.
Daron M VandeleurDepartment of Epidemiology, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA.
Xin ChengDepartment of Epidemiology, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA.
Alyson J LittmanDepartment of Epidemiology, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA.
K Scott BakerDivision of Pediatric Hematology, Oncology, Bone Marrow Transplant & Cellular Therapy, Department of Pediatrics, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195-6540, USA.

Funding

PEDIATRIC ONCOLOGY RESEARCH TRAINING PROGRAMT32CA009351 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI Elizabeth R Lawlor, SOHEIL MESHINCHI · 1985 to 2026
$7.0M
Anesthesiology & Perioperative Medicine Training GrantT32GM086270 · NIGMS · UNIVERSITY OF WASHINGTON · PI Tonya M Palermo · 2009 to 2026
$4.3M
NCI NIH HHS T32 CA009351NIGMS NIH HHS T32 GM086270NIH HHS CA009351NIH HHS GM086270
6 · The paper itself

Abstract

purposeThe impact of adverse childhood experiences (ACEs) on health-related quality of life (HRQOL) is increasingly recognized, however, this has not been studied in cancer survivors in the United States. This study investigates if ACEs are associated with HRQOL in cancer survivors.

methodsWe conducted a cross-sectional analysis of the 2020 Behavioral Risk Factor Surveillance System from states that administered ACEs and Cancer Survivorship modules. Eligibility criteria included being a cancer survivor and not currently receiving cancer treatment. Primary exposure was number of ACEs (categorized as 0, 1-2, 3, or ≥ 4). Primary outcomes were self-reported measures of HRQOL including worse overall health and ≥ 14 unhealthy days (mentally or physically) per month. Mantel-Haenszel stratified analyses were performed and prevalence ratios were adjusted for age.

resultsOf 5,780 participants, 62.0% were female and 67.8% were ≥ 65 years. Prevalence of worse overall health was 22.5% for individuals with no ACEs compared to 30.2% for 2-3 ACEs (aPR = 1.4, 95% CI 1.2, 1.5) and 38.5% for ≥ 4 ACEs (aPR = 1.7, 95% CI 1.5, 2.0). Prevalence of ≥ 14 unhealthy days was 18.1% with no ACEs compared to 21.0% for 1 ACE (aPR = 1.3, 95% CI 1, 1.3), 29.0% for 2-3 ACEs (aPR = 1.6, 95% CI 1.4, 1.8), and 44.8% for ≥ 4 ACEs (aPR = 2.2, 95% CI 2.0, 2.5).

conclusionsOur study provides novel evidence of the association of multiple ACEs with higher prevalence of poor HRQOL in cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: Screening for ACEs is warranted in all patients to guide targeted interventions to improve HRQOL and mitigate the impact of ACEs on HRQoL in cancer survivors.

Indexed as

Adverse Childhood ExperiencesCancer SurvivorsNeoplasmsQuality of LifeAdolescentAdultAgedBehavioral Risk Factor Surveillance SystemCross-Sectional StudiesFemaleHumansMaleMiddle AgedUnited StatesYoung AdultAdverse childhood experiences (ACEs)Cancer-related painCancer survivorshipHealth-related quality of life (HRQOL)Outcomes

Identifiers

PMID38700620
PMCPMC11608576

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.