Key result
Highest Oxidative Balance Score quartile linked to ~40% lower all-cause mortality among cancer survivors.
Why the study?
No comprehensive measure currently exists to assess oxidative stress levels in cancer survivors that associates with all-cause, cause-specific, and cardiovascular disease mortality.
Does a higher Oxidative Balance Score reduce all-cause, cancer-specific, and CVD mortality in cancer survivors?
Cohort (n=2,131)
Does a higher Oxidative Balance Score reduce all-cause, cancer-specific, and CVD mortality in cancer survivors?
Higher Oxidative Balance Scores are associated with significantly lower all-cause and cancer-specific mortality, but not CVD mortality, in American cancer survivors.
Answers are grounded in this paper and cite their sources.
Supports higher OBS for lower mortality in cancer survivors; hypothesis-generating and should not yet change practice.
Background Numerous studies have established that oxidative stress significantly affects the long-term survival of cancer survivors. However, there is currently no comprehensive measure to assess oxidative stress levels in these individuals that associates with all-cause, cause-specific, and cardiovascular disease (CVD) mortality. This study aims to investigate the relationship between Oxidative Balance Score (OBS) in American cancer survivors and their risks of all-cause, cancer-specific, and CVD mortality. Methods This research included cancer survivors from the National Health and Nutrition Examination Survey dataset covering the 2001–2018 cycles, incorporating appropriate weighting. The OBS, a composite index reflecting oxidative stress status, was constructed based on 16 dietary components and 4 lifestyle factors, with higher OBS indicating greater antioxidant capacity. Using multivariable Cox regression, restricted cubic splines analysis (RCS), subgroup analysis, and sensitivity analysis, we examined the associations between OBS and all-cause, cancer-specific, and CVD mortality, including further stratified analyses for specific cancer types and populations. Results The study enrolled 2,131 eligible cancer survivors, with a median follow-up of 115 months and 673 recorded deaths. Weighted multivariable Cox regression results showed that each unit increase in OBS was associated with a 3% decrease in all-cause mortality (Hazard Ratios [HR]: 0.97, 95% Confidence interval [CI]: 0.95, 0.99, p = 0.006). Among participants, those in the highest OBS quartile (Q4) had a 40% lower risk of all-cause mortality compared to those in the lowest quartile (Q1) (HR: 0.60, 95% CI: 0.41, 0.88, p = 0.009). A similar significant association was found with cancer-specific mortality, while no significant association was noted for CVD mortality. RCS analysis further highlighted a significant linear negative association. Subgroup analyses indicated stronger associations with all-cause and cancer-specific mortality among breast cancer patients, those without stroke or arthritis individuals. Sensitivity analysis confirmed the robustness of these findings. Conclusion The study reveals a significant linear negative association between OBS in cancer survivors and both all-cause and cancer-specific mortality.
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He et al. (2025) conducted a cohort in Cancer survivors (n=2,131). Oxidative Balance Score (OBS) vs. Lowest quartile (Q1) was evaluated on All-cause mortality (HR 0.60, 95% CI 0.41-0.88, p=0.009). Being in the highest Oxidative Balance Score quartile was associated with a 40% lower risk of all-cause mortality compared to the lowest quartile among cancer survivors.
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