Kaiser Permanente Research Shows Childhood Sexual Abuse Decreases Rate of Adult Women's Cervical Cancer Screening

OAKLAND, Calif. -- Women who were sexually abused as children are less likely to get Pap tests to screen for cervical cancer, according to research published in the October issue of the Journal of Family Practice. While researchers and clinicians know that sexual abuse in childhood has long-lasting negative effects on women's health, this study reveals that the consequences of childhood sexual abuse extend to preventive healthcare.

Kaiser Permanente researchers Melissa Farley, PhD, Jacqueline M. Golding, PhD and Jerome R. Minkoff, MD, compared 364 female health plan members who received medically appropriate Pap tests with 372 women who had not. Only 36 percent of the women who were sexually abused as children obtained Pap tests within the past two years, compared to 50 percent of women who were not sexually abused as children.

"Women who were sexually abused in childhood have many risk factors for cervical cancer, so it's crucial for them to get screened," Farley says. "Unfortunately, the sexual trauma that increases their risk of disease may also make them less likely to have cancer screening. A pelvic examination may trigger psychological distress in survivors of sexual abuse."

Farley, Golding and Minkoff also note: "This study suggests to us that doctors and nurses should be especially aware of patients who are reluctant to have Pap tests. Those women may have been sexually traumatized as children, in which case they need care for psychological trauma and as well as special outreach to encourage them to obtain Pap tests."

Source: Kaiser Permanente and PRNewswire

Book Review

FORENSIC MEDICAL INVESTIGATIONS
By Mary H. Dudley, MD, MSN, RN

Forensic Medical Investigations is a five-volume series of manuals and an intelligent body of work from a widely respected medical examiner and pioneer in forensic nursing education. Dudley currently serve as chief medical examiner/district coroner for the Sedawick County (Kansas) Regional Forensic Science Center. A Comprehensive Review was written for beginners and experienced practitioners alike and covers an introduction to forensic science, injury patterns, natural disease, accidental trauma, child fatality and domestic violence. Introduction to Pathology, co-written with Thomas Taggart, EdD, LELFD, director of the mortuary science program at Mesa Community College, the text lays the foundation of general and systemic pathology before delving into forensic pathology and mass fatalities. Forensic Protocols is a handy reference manual that compiles sample forms to report everything from a hospital death, MVA, sexual assault or homicide. Forensic Case Studies and Certification Exam Questions are helpful study aids for investigators seeking credentials. Taken separately or as a set, Dudley's texts are informative without being exhaustive; the right breadth and depth for busy professionals needing reliable information.

TECHNIQUES OF CRIME SCENE INVESTIGATION
By Barry A.J. Fisher
CRC Press,

Stronger than ever in its sixth edition, Techniques of Crime Scene Investigation is still required reading for members of the forensic science community. Fisher is crime laboratory director for the Los Angeles County Sheriff's Department and adjunct professor in the Department of Criminal Justice at California State University, Los Angeles. The 550-plus pages are the result of a half century of knowledge building by the original European authors and subsequent American authors; new topics have been added as the breadth and depth of forensic science and technology evolve. New material in the sixth edition includes the challenges facing forensic science laboratories; expert witness testimony; forensic DNA testing; forensic databases such as CODIS; elder abuse; professional ethics; health and safety issues at crime scenes; and a commentary of the O.J. Simpson case. This authoritative text is a must-read for forensic nurses working as death investigators because it nicely integrates hundreds of identification, collection, documentation and processing protocols. The chapter on the investigation of sexual assault and domestic abuse crimes warrants attention, as do other valuable chapters that can be applied to the clinical environment many nurses know best.

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