Adverse childhood experiences (ACEs) are associated with worse health outcomes in adults, including cancer and cardiovascular disease. This study investigated associations between Conventional and Expanded ACEs and preventive care screenings.

Secondary data from the 2012 Southeastern Pennsylvania Household Health Survey and Philadelphia ACEs Survey was used to identify screening gaps for blood pressure (BP), HIV, breast, cervical, and colorectal cancers (CRC), and ACEs. Weighted logistic regression with robust standard errors identified associations between ACEs and screening gaps, accounting for Conventional and Expanded ACE co-occurrence. Adjusting for race and socioeconomic status, sex-stratified models based on a conceptual framework were age-limited to account for appropriate USPSTF screening guidelines.

Associations differed by sex and ACE exposure type. For men, marginal associations surfaced for categorical Conventional ACEs and BP screening gaps (adjusted odds ratio [aOR]=3.41; 95% confidence interval [CI]: 0.97–11.99), Expanded ACEs and CRC screening gaps (aOR=0.21; 95% CI: 0.04–1.03), and Co-occurring ACEs and HIV screening gaps (aOR=0.57; 95% CI: 0.33–1.00). For women, Co-occurring ACEs were marginally associated with CRC screening gaps (aOR=1.84; 95% CI: 0.97–3.49). Sensitivity models using continuous ACE exposures produced slightly different relationships, which was expected due to different parameterizations.

Sex differences emerged showing marginal associations between ACEs and preventive screening gaps. Relationships varied based on ACEs operationalization. Accounting for overlapping Conventional and Expanded ACEs strengthens interpretability and relevance. With marginal relationships and a relatively small cohort, this work should be considered exploratory, generating hypotheses for future work, rather than establishing definitive relationships.