Cervical cancer, which is primarily caused by persistent infection with high-risk human papillomavirus (HPV), is a significant global health concern.
Cervical cancer is less common in the U.S., but is one of the most common cancers that affects women worldwide, especially in lower-income countries.
A new study examined the relationship between dietary antioxidant intake and cervical cancer and found that higher antioxidant intake was associated with a lower prevalence of the disease.
The study was published in the International Journal of Gynecology & Obstetrics.
There were more than 600,000 cases of cervical cancer and about 342,000 deaths from the disease worldwide in 2020.
Although HPV vaccination and cervical cancer screening can help prevent the disease, access to these preventive measures is uneven, particularly in lower-income countries.
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Researchers are also interested in identifying additional modifiable factors that may contribute to the development of cervical cancer, including nutrition.
For the new study, scientists analyzed data from the National Health and Nutrition Examination Survey (NHANES), a program that assesses the health and nutritional status of people in the U.S.
The researchers included 1,044 participants in their analysis. Of these, 174 had a self-reported history of cervical cancer, and 870 participants without cervical cancer served as matched controls.
The team analyzed the participants’ diets using two nonconsecutive 24-hour dietary recall interviews. They then calculated each participant’s Composite Dietary Antioxidant Index (CDAI).
The CDAI provides an overall measure of dietary antioxidant intake based on six components:
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Higher CDAI scores indicate higher overall dietary antioxidant intake. Antioxidants may help protect against oxidative stress and inflammation, which the researchers thought may contribute to HPV infection and cervical cancer development.
The researchers used CDAI scores to examine whether overall antioxidant intake was associated with the prevalence of cervical cancer.
They also accounted for factors such as age, race and ethnicity, income, smoking and alcohol use, and BMI.
After accounting for these factors, the researchers found that each 1-unit increase in CDAI score was associated with 11.4% lower odds of having a history of cervical cancer.
Participants with the highest dietary antioxidant intake had about 56% lower odds of having a history of cervical cancer than those with the lowest intake.
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The study authors said that antioxidants may affect oxidative stress, inflammation, and immune responses, which could help explain the association. However, the findings do not show that a higher antioxidant intake prevents cervical cancer.
The study had several limitations, including its cross-sectional design. Since the researchers assessed participants’ diets and cervical cancer history at a single point in time, they could not determine whether diet influenced cancer development or whether participants changed their diets after diagnosis.
Participants also self-reported their cervical cancer diagnoses, and researchers did not have information about cervical cancer stage at diagnosis.
The authors say that future studies should follow participants’ diets over time to better understand whether antioxidant intake affects cervical cancer development.
Jagdish Khubchandani, PhD, MPH, a public health professor at New Mexico State University, shared his thoughts on the study with Medical News Today.
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Khubchandani noted that while studies using NHANES data can provide valuable insights, dietary research has limitations, including relying on participants accurately recalling what they eat.
However, he said there are several biological mechanisms that could help explain the findings.
“Antioxidants in many dietary items (e.g., fruits and veggies) neutralize these toxins that can damage DNA in cells,” Khubchandani explained. “Furthermore, antioxidants, vitamins, and minerals in healthy diets also protect our tumor-suppressing proteins.”
“The science is well established that healthy diets reduce the risk of cancers,” he said, adding that greater attention should be paid to improving “access, cost, and lifestyles.”
Khubchandani recommends aiming for five servings of fruits and vegetables daily when possible, while emphasizing that diet cannot prevent HPV infection when other risk factors are present.
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“Good diets can ensure a strong immune response to any infection,” Khubchandani emphasized.
Laurie Brunette-Masi, MD, a board certified gynecologic oncologist at City of Hope Orange County in Irvine, California, told MNT that the findings should be interpreted cautiously.
“It is important, however, not to interpret this as proof that antioxidants prevent cervical cancer,” said Brunette-Masi. “This was an observational study that shows an association, not cause and effect.”
Brunette-Masi noted that antioxidants are part of a healthy lifestyle and may help support immune function, but emphasized that HPV vaccination and recommended cervical cancer screening are “the foundation” of cervical cancer prevention.
“A healthy diet may be another piece of the prevention picture, but it should complement, not replace, these proven measures,” said Brunette-Masi.
