Researchers propose solutions to address sex disparities in medicine, oncology
Despite calls to recruit and advance the careers of women scientists, little guidance exists on how exactly to achieve that goal and subsequently reduce sex disparities in medicine, researchers wrote in a JAMA Oncology viewpoint.
This is especially true for oncology, where women continue to be underrepresented in leadership positions, as grant recipients and as lead investigators on trials, the authors added.
Kristina Jenei, BSN, MSc, lead author of that viewpoint, has become deeply interested in the cancer care field and has identified specific disparities that affect women in oncology.
Jenei, a nurse and research coordinator at the School of Public Health of University of British Columbia, also co-authored a study published in JAMA Oncology last year that showed only 40% of the participants of 505 oncology clinical trials she and colleagues evaluated were women.
“I spoke with Healio previously about another study focused on the proportion of women included in global clinical trials in which women were underrepresented,” Jenei said.
She continued that the research from that first study spurred further interest in the topic of women and oncology. She noted that they found a “flurry” of research and commentary about the underrepresentation of women.
“This is great because it provides more light and knowledge to paint a more accurate picture of women in different leadership positions, especially in academic medicine,” Jenei said. “My co-authors and I were speaking about it. It was quite depressing, to be honest, so we felt the need to write a commentary. We wanted to look at what things we can do to address some of these disparities that are constantly outlined in the literature.”
Facing sex disparities
During her time focused on oncology and her recent research into sex disparities, Jenei has identified some specific issues of note.
“We cited the European Medical Society for Medical Oncology survey that was sent out to men and women, which highlighted some misunderstandings,” she said. “This is particularly specific to academic medicine and leadership positions. Data showed men answered that women wouldn’t want to seek those higher positions, whereas women answered that it was something they do seek.”
Further, women may often serve as a primary caregiver or need to take maternity leave, whereas men are not as regularly provided paternity leave, which can lead to women having less time to focus on growing their career. The ESMO survey specifically showed that over half of the women respondents reported being a primary caregiver compared with only 1.2% of men respondents.
“What was most concerning was that nearly 40% of women reported encountering an unwanted sexual comment from a colleague or superior,” she said. “That is clearly a large percentage of women and suggests that this may really be a deeply ingrained bias, a cultural issue that needs to be addressed.”
Focus for the future
Jenei and her colleagues provided suggestions to address these disparities at the individual, institutional and national levels.
Citing Canada as an example, where men and women have achieved equal representation in leadership positions, policies that implemented institutional accountability via gender mandates appear to have been successful. Similar policies that encourage transparency and accountability with continuous evaluations can be implemented in the U.S. health system, perhaps at the NIH and NCI, Jenei and colleagues wrote.
The authors also suggested that results of the ESMO survey can be used to inform flexible work environments for women with caregiver duties, gender-neutral parental leave and zero-tolerance sexual harassment policies.
Individual-level support is necessary to promote women becoming principal investigators of grant-funded studies, Jenei and colleagues wrote, suggesting academic institutions provide transparent salary information, formal mentorship programs and career advising.
“In terms of specific organizations, we believe published progress reports that outline funding and establish clear objectives could improve sexual disparities, including reviewing, outlining and monitoring diversity,” Jenei said.
References:
- Banerjee S, et al. ESMO Open. 2018;doi:10.1136/esmoopen-2018-000422.
- Jenei K, et al. JAMA Oncol. 2021;doi:10.1001/jamaoncol.2021.3686.
- Jenei K, et al. JAMA. 2022;doi:10.1001/jamaoncol.2022.0165.
For more information:
Kristina Jenei, BSN, MSc, can be reached at kjenei@mail.ubc.ca.
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