Long-term impact of childhood exposure to interparental physical violence on cancer risk in adulthood: a prospective cohort study

Abstract

ABSTRACT Background: Adverse childhood experiences (ACEs) are known to contribute to increased long-term cancer risk. However, the specific association between childhood exposure to interparental physical violence and the incidence of cancer in adulthood remains poorly understood. Methods: This prospective cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), which included 11,825 participants aged 45 years or older enrolled from 1 June 2011, and followed until 31 December 2020. Exposure to interparental physical violence during childhood was assessed via a life history questionnaire evaluating the frequency of witnessing physical violence between parents. Depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale. The primary outcome was physician-diagnosed cancer (excluding minor skin cancers), identified through follow-up self-reports. Multivariable Cox proportional hazards regression models with attained age as the time scale were employed for analysis. Results: Among the 11,825 participants (mean age 58.4 ± 9.0 years; 52.2% female), childhood exposure to interparental violence was significantly associated with an elevated risk of cancer (HR = 2.97, 95% CI: 1.52–5.80). A significant dose–response relationship was observed (p for trend < 0.01). Depressive symptoms were more prevalent in the exposed group and mediated approximately 28.9% of the total association between violence exposure and cancer risk (HR = 2.40, 95% CI: 1.13–5.11). Conclusions: In a national cohort, childhood exposure to interparental violence was associated with an elevated risk of adult cancer incidence, partly through depressive symptoms. Preventing domestic violence and early psychological intervention may reduce long-term cancer burden.