Integrating gender into cancer research
Authors: Amalia Martinez, Cyrille Delpierre, Pascale Grosclaude, Sébastien Lamy
Journal: The Lancet (2024)

As cancer epidemiologists, we support the recommendations of The Lancet Commission on women, power, and cancer,1Ginsburg O Vanderpuye V Beddoe AM et al.Women, power, and cancer: a Lancet Commission.Lancet. 2023; 402: 2113-2166Summary Full Text Full Text PDF PubMed Scopus (14) Google Scholar which emphasised favourable structural contexts, routine data collection, and the prioritisation of research. Regularly collecting data on sex, gender, and socioeconomic factors in cancer statistics is essential for understanding health inequalities among populations. Providing these indicators enables health-care practitioners to personalise health care according to the specific needs of these populations. Updated indicators allow trend monitoring and assessment of the impact of public health programmes among targeted populations, vital for reducing cancer incidence inequalities. As researchers addressing social health inequalities from an intersectional perspective, we need methodological competencies to integrate gender mechanisms into our analyses. A literature review that we conducted on differences in colorectal cancer incidence in men and women showed very few studies investigating these differences. Where researchers were trying to understand the origin of these differences, we noticed a confusion between the terms sex and gender, which made it difficult to identify whether the underlying mechanisms being referred to were modifiable gender-related mechanisms or non-modifiable sex-related mechanisms, or both. A methodological framework for gender integration in research is essential, exemplified by the work of Colineaux and colleagues.2Colineaux H Soulier A Lepage B Kelly-Irving M Considering sex and gender in epidemiology: a challenge beyond terminology. From conceptual analysis to methodological strategies.Biol Sex Differ. 2022; 13: 23Crossref PubMed Scopus (8) Google Scholar Their analytical strategy operationalises gender and sex mechanisms and the ways in which these mechanisms interact to produce a state of health. To understand differences between men and women in oncology, it is essential to integrate a gendered dimension into the analyses in addition to the sex assigned at birth. A conceptual framework is necessary to capture diverse gender mechanisms. To develop efficient cancer prevention interventions for populations that are discriminated against, researchers advocate for considering intersectionality through rigorous methodologies2Colineaux H Soulier A Lepage B Kelly-Irving M Considering sex and gender in epidemiology: a challenge beyond terminology. From conceptual analysis to methodological strategies.Biol Sex Differ. 2022; 13: 23Crossref PubMed Scopus (8) Google Scholar, 3Jackson JW Explaining intersectionality through description, counterfactual thinking, and mediation analysis.Soc Psychiatry Psychiatr Epidemiol. 2017; 52: 785-793Crossref Scopus (23) Google Scholar, 4Bauer GR Incorporating intersectionality theory into population health research methodology: challenges and the potential to advance health equity.Soc Sci Med. 2014; 110: 10-17Crossref PubMed Scopus (901) Google Scholar that differentiate between gender and sex mechanisms. We declare no competing interests. AM is supported by the Gendhi project, funded by the European Research Council under the EU's Horizon 2020 framework programme for research and innovation (grant agreement 856478). SL, PG, and CD are supported by the Ligue contre le cancer as part of the labelling process. Women, power, and cancer: a Lancet CommissionWomen interact with cancer in complex ways, as healthy individuals participating in cancer prevention and screening activities, as individuals living with and beyond a cancer diagnosis, as caregivers for family members and friends, as patient advocates, as health workers and health-care professionals, and as cancer researchers and policy makers. Full-Text PDF