Opinion Lancet report on cancer in women is a wake-up call

A new Lancet Commission report on gender inequity in cancer care lays out in stark numbers what has long been known anecdotally. While women have approximately the same burden of cancer as men, with 48 per cent of new cases and 44 per cent of deaths worldwide, the toll it takes on them is disproportionately higher. The authors of the “Women, Power and Cancer” commission’s report have examined how asymmetries of power in relation to cancer play out in terms of decision-making, knowledge and economics in 185 countries. The findings are dispiriting: Not only is cancer one of the top three leading causes of premature deaths among women worldwide, but women are less likely to find the care they need once diagnosed, due to a lack of knowledge and decision-making power. They are also more likely to experience “financial catastrophe” due to cancer. In India, nearly two-thirds of the cancer deaths in women, the authors found, were preventable and 37 per cent were treatable if only they had been caught in time and received optimal care.

These findings show how gender dynamics play out when it comes to health: Globally, when women remain primarily valued for and defined by their reproductive role, women’s health too gets reduced to maternal and reproductive health. Combine this with the fact that, from lack of autonomy to little or limited access to education, employment and healthcare, a range of factors ensures that women — especially from marginalised communities and in nations that rank low on the human development index — rarely go in for the tests and screenings that can help with early detection and treatment. These structural asymmetries play out in other ways too. Consider, for example, the under-representation of women in the oncology workforce as leaders and decision-makers. It is no coincidence that even as the most common cancer among women around the world is breast cancer, very little is still understood about its causes and the occupational and environmental hazards that could lead to cancer in women are woefully under-researched.

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Given that a lack of understanding of how women are systematically disadvantaged when it comes to cancer care is at the root, measures that fill these gaps must be a priority, including the collection and updation of sociodemographic data in cancer healthand more research on risks that impact women. Also needed is greater sensitivity and responsiveness to the challenges that lie at the intersections of power, status and identity by all stakeholders — right from institutions and policy — and decision-makers at the top to those who raise awareness and are involved in the treatment and care of the affected women.