international day of women and girls in science: why gender disparities in health matter
integrating women into our lexicon is a necessary step in promoting a more inclusive understanding of healthcare.
4 minute read
women's overlooked contributions in scientific realms mirror their underrepresentation and exclusion in healthcare particularly in the context of cancer.
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there have been countless scientific discoveries made by women, yet attributed to men. consider biophysicist rosalind franklin’s discovery of the double helix — a double-stranded dna molecule — that was attributed to the work of american biologist james watson and english physicist francis crick. in 1905, dr. nettie stevens challenged conventional beliefs about sex determination, demonstrating that the y chromosome plays a pivotal role in male development. despite stevens’ pivotal findings, her mentor e.b. wilson received credit for the discovery. how does this connect to gender disparities in healthcare? women’s overlooked contributions in scientific realms mirror their underrepresentation and exclusion in healthcare particularly in the context of cancer. breaking the ice on gender disparities in healthcare reveals a complex web of biases that impact women’s well-being in profound ways, and cancer care is no exception.
focus on male symptoms put women at risk
the terms ‘sex’ and ‘gender’ are not interchangeable. according to the canadian institutes of health research, sex refers to the biological differences between males and females, and encompasses sex organs, endogenous hormones and chromosomes. gender, however, is a sociocultural construction that encompasses the roles, norms and behaviours expected for males and females in society, which may or may not correspond to their sex.
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differences between sexes have far-reaching effects on various aspects of cancer, including its epidemiology, pathophysiology (how and why a cancer starts and grows), clinical manifestations (signs and symptoms), disease progression, and response to treatment. current approaches to cancer care, particularly in precision medicine, often overlook the significance of gender and sex. viewing the patient through a sex and gender lens is a first step toward personalized care. precision medicine is a hot topic in cancer care that focuses on the genomic profile of the tumour. approaches to precision medicine use mutational or other genomic data to assign therapy without considering how the sex of the individual might influence therapeutic efficacy. thus, it is unclear whether precision medicine will equally benefit all patient populations or if they will have the unintended consequence of exacerbating preexisting health disparities.
still, research has shown that women often do not receive the same level of treatment for cancer as men. this is unsurprising, since women have historically been excluded from clinical trials, leading to a focus on male physiology in research and medical attention. in fact, the diagnosis, treatment and prevention of disease originates from studies carried out mainly on male cells, male mice and men.
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this underrepresentation of women has created gender-specific gaps in medical and disease knowledge, putting their health at risk, and also perpetuaing disparities in our understanding of drug effects and real world treatment outcomes.
the gender gap and drug development
the gender gap also extends to drug development, where a lack of representation in early-phase clinical trials undermines the accuracy and effectiveness of pharmaceutical interventions. when the clinical evaluation of drugs fails to consider gender differences, it impacts dosing, safety, and efficacy. sex-specific data is critical for understanding how drugs interact with the male and female body differently, yet this information is often neglected in drug development and reporting.
in the context of phase iii clinical trials for new cancer treatments, it is optimal for the study population to closely resemble the demographic that will eventually use these treatments, so when trial populations deviate from the actual disease incidence in society, the reproducibility and generalizability of results become limited. for example, clinical trial data generated in men does not necessarily extrapolate to women, who exhibit a 1.5 to 1.7 times greater risk of experiencing adverse reactions to drugs. they also face higher hospitalization rates due to these reactions, even when accounting for age-related differences.
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the broader challenge lies in the insufficient data or awareness regarding systemic disadvantages faced by women and marginalized groups based on sex or gender. an overarching priority is to integrate sex and gender considerations into all cancer-related policies and guidelines. this ensures responsiveness to the diverse needs of women in various roles — as healthy individuals engaged in cancer prevention, individuals living with and beyond cancer diagnoses, caregivers, patient advocates, healthcare providers, cancer researchers and policymakers.
a comprehensive and gender-transformative approach to the field of cancer field is crucial. this includes collecting sex-disaggregated data in all cancer health statistics, studying the emerging cancer risk factors that disproportionately affect women, and establishing economic frameworks recognizing the contributions of often unpaid women serving as cancer caregivers.
these disparities underscore the systemic challenges that persist in our healthcare systems. it is essential to shift our perspective: men should not be the standard by which we understand women’s health. integrating women into our lexicon is a necessary step in promoting a more inclusive understanding of healthcare.
