Sexual assault and cancer pathways: a scoping review of biomedical and screening outcomes

Sexual assault (SA) is a pervasive global health problem with long-term psychological and physical consequences. While the mental health effects of SA are well documented, growing evidence suggests that SA may increase cancer vulnerability through biological, behavioural, and healthcare-access mechanisms.

To examine the relationship between SA and cancer-related outcomes with a focus on behavioural and infection-related mechanisms reported in empirical studies.

A scoping review was conducted of studies published between 2000 and 2025 in PubMed. Eligible studies reported cancer outcomes among SA survivors. Data were extracted on study design, population characteristics, and effect measures. This scoping review followed PRISMA-ScR reporting guidance.

Twelve studies met inclusion criteria. Survivors demonstrated lower participation in cervical and breast cancer screening (reductions of 20-40%), higher cancer-related infection rates (relative risk 1.13-1.9), and greater odds of cancer or precancerous disease (OR 1.27-4.5). Qualitative findings described distress and re-traumatisation during pelvic examinations as major screening barriers.

Sexual assault is associated with increased cancer vulnerability through converging biological, behavioural, and structural pathways. Incorporating trauma-informed approaches into cancer prevention, screening, and treatment is essential to addressing this overlooked aspect of survivor health.