The Global Imbalance in Cancer Access and Care: A Call for Gender Equality

Recent research from a Lancet Commission has shed light on the profound gender inequalities that affect women’s access to cancer prevention, detection, and care. The report emphasizes that cancer remains one of the leading causes of premature death among women worldwide. Shockingly, 2.3 million women die prematurely from cancer each year, and a significant number of these deaths could be prevented through early diagnosis, eliminating risk factors, and improving access to optimal care. The Lancet Commission strongly asserts that gender inequalities and discrimination are key factors that impede women’s ability to avoid risk factors and receive timely and quality cancer care. To address this issue, the report calls for a “new feminist agenda” to eliminate gender inequality in cancer.

The Lancet Commission report highlights the unrecognized impact of patriarchal societies on women’s experiences with cancer. Co-Chair of the Commission, Ophira Ginsburg, MD, emphasizes that gender inequalities significantly affect women’s encounters with cancer. Therefore, it is crucial to prioritize cancer as a women’s health issue and implement a feminist approach to cancer care. The report also points out that gender inequalities extend beyond “women’s cancers,” such as breast and ovarian cancers, to include lung and colorectal cancers, which significantly contribute to cancer-related deaths among women globally. In particular, lung cancer deaths in women have surpassed breast cancer deaths in many high-income countries due to targeted marketing by the tobacco and alcohol industry. The report recommends that gender-specific policies be implemented to increase awareness and reduce exposure to these risk factors.

In addition to highlighting the impact of gender inequality, the Lancet Commission report identifies several key issues and proposes corresponding action points. These include the following findings:

1. Cancer poses unique challenges for primary prevention in women.
2. Women in countries with a low Human Development Index experience a high proportion of premature cancer deaths.
3. Women lack the knowledge and power to make informed decisions about cancer prevention and care.
4. Patriarchy dominates cancer care, research, and policy, allowing those in power to determine priorities and funding.
5. Women are underrepresented in leadership positions within healthcare.
6. Women in the cancer workforce frequently encounter severe gender-based discrimination.
7. Women are often the primary unpaid caregivers for individuals with cancer.

To address these issues, the report suggests a comprehensive approach with the following priorities for action:

– Improve data collection and cancer statistics to better understand gender disparities.
– Develop policies to address risk exposures that disproportionately affect women.
– Monitor emerging cancer risks specific to women.
– Implement strategies to achieve equitable access to early detection and diagnosis.
– Establish responsive and accessible health systems that provide quality care for women and girls.
– Promote equitable access to cancer research resources, leadership, and funding.
– Address gender-based harassment and discrimination within the cancer workforce.
– Incorporate gender competency into cancer education and training.
– Apply a feminist economics approach to economic evaluations of cancer.
– Implement fair and inclusive pay standards.

Although some may perceive the report’s findings as predominantly applicable to developing and underdeveloped nations, the Lancet Commission report explicitly highlights the relevance to the United States and other developed countries. The report emphasizes that gender-based inequities in access to care may be more pronounced in certain regions but that the impact of gender inequality extends beyond patient care. The report addresses gender disparities within the cancer workforce, the role of women as caregivers and decision-makers, and broader issues of gender inequality’s influence on cancer prevention, detection, treatment, and outcomes.

Julie Gralow, MD, Chief Medical Officer for the American Society of Clinical Oncology, emphasizes that the report underscores the far-reaching impact of a cancer diagnosis on women, their families, and society as a whole. The report draws attention to the alarming number of estimated orphans worldwide resulting from a cancer death in a young woman. Furthermore, the report emphasizes that addressing gender inequalities in cancer extends beyond patient care to include the broader societal implications.

Dr. Erin Medlin, a spokesperson for the Society of Gynecologic Oncology, concurs with the report’s applicability to the U.S. She asserts that gender disparities in access to care and its quality persist globally and within the United States. The report echoes the critical importance of prevention and access to safe and high-quality care for all individuals. By acknowledging the intersectionality of factors impacting women and cancer, including financial, geographic, socioeconomic, cultural, and religious influences, the report calls for comprehensive efforts toward closing the gender gap.

The Lancet Commission report provides a wake-up call to recognize and address the gender inequalities that impact access to cancer prevention, detection, and care. It highlights the urgent need for a feminist approach to cancer, emphasizing the importance of prioritizing women’s health and eliminating gender disparities in cancer-related policies and practices. By implementing the proposed action points, governments, healthcare providers, researchers, and policymakers can work towards a future where women have equal access to effective cancer prevention, early diagnosis, and optimal care. Only by challenging gender inequalities head-on can we ultimately make progress in eradicating cancer as a leading cause of premature death among women worldwide.

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