Abstract
BACKGROUND: Oxidative stress has been implicated in the pathogenesis of various malignancies, including gynecological cancers (GC). This study aimed to evaluate the association between oxidative balance score (OBS) and GC prevalence using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. METHODS: A total of 7816 adult female participants were included, of whom 195 reported a history of GC (cervical, endometrial, or ovarian). OBS was computed from 20 components: 15 antioxidants and five pro-oxidants from dietary and lifestyle sources. Multivariable logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for GC according to the OBS tertiles and per-unit increases, adjusting for covariates. RESULTS: Higher total OBS was associated with significantly lower odds of GC (adjusted OR per unit increase = 0.92; 95% CI: 0.86-0.97). Participants in the highest OBS tertile had 34% lower odds of developing GC than those in the lowest tertile. This association was more pronounced among women aged ≥60 years, non-smokers, and those with normal body mass index (BMI). CONCLUSION: Greater antioxidant exposure, as reflected by higher OBS, was inversely associated with GC risk. These findings support dietary and lifestyle interventions aimed at improving oxidative balance.