“Gender-related issues are not only of interest to female professionals, but the whole oncology community would benefit from ensuring a level playing field,” said Solange Peters, from the Centre Hospitalier Universitaire Vaudois, Lausanne, at ESMO 2019 in Barcelona. Peters is the Chair of the ESMO Women for Oncology Committee, whose role is to actively promote women’s careers in oncology. “Offering the same opportunities to every professional, irrespective of gender, leads to a merit-based system that can advance research and practice and provide optimal care for our patients.”
W40, the state of the art
Peters will take over the presidency of ESMO for 2020-2021, becoming only the second female president after Martine Piccart. At this Forum, she presented data from the W40 study, which monitors the representation of women at major national and international congresses. Data collected in 2018 were compared with data from previous W40 studies, conducted since 2015. In 2018, only 1 out of 6 presidents of oncology societies was a woman, the same as in 2017.
The study also investigated the association between the gender of a society’s president and the gender of the board members. In 2017 and 2018 the gender of the president didn’t influence female representation within the boards. “In an optimistic perspective, this could mean that we already reached the balance, but unfortunately it’s not. We need to be very careful and aware, and we need women in boards and high-level positions to always make the other members focused on the gender gap. If we stop acting, we lose all we gained.”
Women in higher positions are not enough to guarantee fair access to other women. “We face a well-known phenomenon, called the Queen Bee effect,” admits Peters. “Many women, when they reach a position of authority, tend to be even more discriminatory than men, to show that their gender doesn’t influence their choices. What we need is not only a woman at the top level, but an educated and sensitive one, a leader who is aware of the gap and one that proactively engages to fill it.”
The major role of industry
Interesting data also come from the gender analysis of speakers at major oncology congresses. At ASCO 2018, 38% of the speakers were women (vs 29% in 2009), compared with 39% at ESMO 2018 (vs 26% in 2009). Asian women are underrepresented at congresses (only 24% of women in 2018) if compared with European (37%) and American (41%) women.
Looking at oncology journals, women are first authors in only 38% of the papers (vs 62% male first authors) and are last author in 30% of the cases (vs 70% male last authors).
There are many reasons for these differences, but industry also plays a major role. “In congresses on clinical oncology, we often present the latest results from clinical trials. And women are rarely selected to be the coordinator of large clinical trials, or the key opinion leader. Both are roles that are often decided by the company supporting the study,” said Peters. “We have to work with them to change the criteria they use to choose the trial coordinators.”
In the end, the problem is that the number of women speakers is largely inadequate considering that in 2018, 38% of ESMO members were women, and women were more than half of the members (54%) in the under-40 age group.
“We need to monitor the situation closely and keep on collecting data for future updates of the W40 study,” commented Peters. “And we need to raise awareness about the gender issue, planting the seeds for a gender-balanced future.”