Gender inequality, discrimination impede women’s cancer care: Lancet Commission


At least 63 percent of cancer deaths among women in India could have been prevented by reducing risk factors, the latest Lancet Commission report has stated. The report on gender and cancer treatment based on 2020 data has said that at least 6.9 million cancer deaths among women in India were preventable, 4.03 million were treatable, and 37 percent of the deaths could have been prevented with appropriate and timely treatment.

The latest Lancet report focuses on “Women, Power and Cancer” and highlights a societal indifference towards women’s health. The report states that unequal power dynamics across society have resounding negative impacts on how women interact with cancer prevention, care, and treatment. The Lancet Commission has pointed out – gender inequality and discrimination influence women’s rights and opportunities to avoid cancer risk factors and impede their ability to seek and obtain timely diagnosis and quality cancer care.

The new report, Women, Power, and Cancer: A Lancet Commission, brings together a multidisciplinary and diverse team from around the globe, including scholars with expertise in gender studies, human rights, law, economics, social sciences, cancer epidemiology, prevention, and treatment, as well as patient advocates, to analyze how women around the world experience cancer, and to provide recommendations to policymakers, governments, civil society, and health and social care systems.

Calling for gender and sex-inclusive policies and guidelines, the report also points out that women are not often in a position where they can determine the nature of their care. “The impact of a patriarchal society on women’s experiences of cancer has gone largely unrecognized. Globally, women’s health is often focused on reproductive and maternal health, aligned with narrow anti-feminist definitions of women’s value and roles in society, while cancer remains wholly under-represented,” says Dr Ophira Ginsburg, Senior Advisor for Clinical Research at the National Cancer Institute’s Center for Global Health and co-Chair of the Commission. “Our Commission highlights that gender inequalities significantly impact women’s experiences with cancer. To address this, we need cancer to be seen as a priority issue in women’s health, and call for the immediate introduction of a feminist approach to cancer.”

The report says that gender inequalities have resulted in an unpaid caregiver workforce that is predominantly female and “hinder women’s professional advancement as leaders in cancer research, practice, and policymaking, which in turn perpetuate the lack of women-centered cancer prevention and care”.

“Unpaid caregiving for those with cancer is also largely undertaken by women and is undervalued by society,” the report says. A new analysis of five countries by the Commission finds the value of women’s unpaid caregiving work for those with cancer ranges from 2% of national health expenditure in Mexico to 3.7% of national health expenditure in India. The Commissioners argue caregiving represents substantial value to the economy and calls for the establishment of fair and inclusive pay standards for cancer caregivers, considering not only its monetary value but also the effects of caregiving on women’s independence and economic potential.

“Even the causes of breast cancer, the most common cancer among women globally, are poorly understood, and of the risks identified, most (such as genetics and reproductive factors) are not amenable to change. More research is urgently needed to better understand the causes of cancer in women, including occupational and environmental factors, some of which have only been raised as potential hazards over the past 5 –10 years,” the report observed.

The Commission has called for a new feminist agenda for cancer care to eliminate gender inequality where health systems, cancer workforces, and research ecosystems are more inclusive and responsive to the needs of women in all their diversities, therefore reducing the global burden of cancer.

“Gender norms mean women are often expected to prioritize the needs of their families at the expense of their own health, sometimes leading to the postponement of seeking healthcare. This can be exacerbated as gender norms also exclude men from participating in childcare in many settings, meaning it’s hard for a mother to find childcare while they seek care for their own health needs,” adds co-author Prof Nirmala Bhoo-Pathy, Universiti Malaya and Queen’s University Belfast.

To counter the negative impact of gender inequality and transform the ways women interact with the cancer health system, the Commission argues for sex and gender to be included in all cancer-related policies and guidelines, making them responsive to the needs and aspirations of all women, whether they be patients, care providers or researchers.

The Commissioners call for strategies targeted at increasing women’s awareness of cancer risk factors and symptoms, along with increasing equitable access to early detection and diagnosis of cancer. Through training programs and leadership, it should be possible to create accessible and responsive health systems that provide respectful, quality cancer care for women in all their diversities. “To ensure there is equal representation of women in leadership positions within the cancer workforce, there must be fair access to cancer research resources, leadership, and funding opportunities for women,” the Commission has said in its report.

“Our Commission exposes the asymmetries of power that influence women’s experiences of cancer and makes the recommendations required to advance an intersectional feminist approach that would reduce the impact of cancer for all. In a society where women’s autonomy is infringed, it’s imperative that researchers, policymakers, organizations, and healthcare providers do all they can to meet women’s diverse and unique needs during their experiences of cancer care,” says co-author Dr. Shirin Heidari, president of GENDRO and senior researcher at Gender Centre, The Geneva Graduate Institute.

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