Key takeaways
- Research has identified an association with a history of sexual violence and an increased risk of cancer.
- Survivors of sexual violence are more likely to require regular medical attention. It is important to understand the cancer risks in this population and the barriers they may face when accessing healthcare services.?
- Exposure to cancer risk factors may contribute to cancer risks in this population. Additionally, social isolation and previous trauma can deter survivors from accessing healthcare services or taking part in screening programmes.?
- A trauma informed and sensitive approach is essential when consulting with survivors of sexual violence.?
1 in 6 people in the UK will experience sexual violence at some point in their life.?
Multiple studies have identified an association between a history of sexual violence and an increased risk of cancer, but the reasons for this are complex and not fully understood.?
Potential pitfalls: Risk factors and barriers.
Although many studies have reviewed the association of cancer with women and childhood survivors of sexual violence, the key messages are still applicable to adults of all gender identities.
- Survivors of sexual violence are more likely to engage in harmful health behaviours such as alcohol excess, smoking, sexual behaviours associated with increased risk, and obesity.
- Sexual assault may increase an individual’s risk of developing certain cancers due to the exposure to human papillomavirus (HPV) and some sexually transmitted infections, such as HIV.
- Mental health issues and the psychological effects of past trauma may influence health-seeking behaviours.
- Individuals fleeing abusive relationships can be more likely to live in poverty, have less education and face fewer employment opportunities, all of which are indirectly linked to poorer cancer outcomes.
- Survivors of sexual violence have historically been identified as a population with a low participation in cancer screening programmes, this may be due to invasive tests involving intimate sites of the body.?
- The emotional or physical trauma from sexual violence can deter survivors from participating in cancer screening programmes, physical examinations, or onward investigations.?
- Social isolation due to intimate partner violence or mental health issues can limit patients access to healthcare services.?
- Patients experiencing intimate partner violence may face limited access to transportation. ?
Helpful hints: A trauma informed approach.?
A trauma–informed and sensitive approach is essential when consulting with survivors of sexual violence.?
Essentials to consider:??
- At the start of the consultation, ask if there is anything you can do to make the appointment easier for the patient and whether there is any language that should be avoided. ?
- Patients may not wish to disclose their experiences, be sensitive to this and make any disclosures as straightforward as possible and minimise what they have to say.?
- Remind patients that they are in control of the situation and that they can stop the consultation or procedure at any time.??
- Check that the patient is happy to proceed with each stage of the consultation and encourage questions throughout.?
- Clearly explain any examinations or procedures and let the patient know that there is no pressure to proceed if they do not feel comfortable to do so.?
- Certain examinations or procedures may need to be tailored to meet the patient’s needs or avoided and alternative steps taken if the patient does not wish to proceed.?
- Allow patients privacy and control over their environment, such as whether the door is locked/unlocked or whether the curtain is pulled around the couch, etc.?
- Building a rapport with patients is important to allow them to feel safe and to promote engagement with services. Where possible, offer patients an appointment with a clinician that they know and feel comfortable with.?
The Survivor’s Trust has released an animation as part of the #CheckWithMeFirst campaign which outlines three simple steps that healthcare professionals can take which make a difference to a survivors’ experiences.?
Health education is essential. Consider using tailored patient education resources from charities that cater to differing languages and literacy levels. ?
The possible introduction of HPV self-sampling in the future may help address some of the barriers to taking part in cervical screening that survivors of sexual violence face.?
Practice takeaway
The Survivors Trust provides useful resources for healthcare professionals, such as a guide for cervical screening in collaboration with The Eve Appeal charity, and trauma-informed patient information cards.?
Explore our cancer screening courses covering breast, bowel and cervical to gain essential guidance on improving uptake and reducing barriers to screening participation in survivors of sexual violence.
