María José Sánchez: "Sex and gender must be included in all public policies related to cancer to adequately address the needs of women in all their diversity."

Women interact with cancer in multiple settings, as healthy individuals involved in prevention and early detection activities, as patients coping with the disease, as caregivers for family and friends, as patient advocates, as health care workers and healthcare professionals, and as researchers and policy makers. Despite this wide variety of roles, Women continue to face significant inequalities that impact their experiences of cancer.

Women have about the same burden of cancer as men, accounting for 48% of new cases and 44% of deaths globally. In almost every country in the world, Cancer is among the three main causes of premature female mortalityOf the 2,3 million women who die prematurely from cancer each year, an estimated 1,5 million of these deaths could be prevented through primary prevention strategies, eliminating exposure to major risk factors, and promoting early detection and diagnosis, while another 800.000 deaths could be prevented each year if all women had access to better health care. Several studies have shown that compared to men, women with cancer are more likely to not receive adequate pain relief treatments.

There are several factors that mean that women face greater barriers to accessing adequate care. In many countries, women do not have the power or information necessary to make informed decisions about their health care. In addition, women are more likely to experience a financial crisis due to cancer, with serious repercussions for their families. This financial burden also affects caregivers, who are mostly women and whose unpaid work is rarely recognized or valued fairly.

Patriarchy and gender inequality extend to cancer research and care as well. Globally, women are underrepresented in leadership positions in cancer research, treatment and public policy. This impacts which research is prioritised and funded, and which aspects of the disease receive more attention. Women are therefore not only affected as patients, but also as workers and researchers in the oncology field.

On the other hand, the causes of breast cancer, the most common cancer in women, are not well known and, of the identified risks, most, such as genetics and reproductive factors, are not susceptible to change. This highlights the urgent need for more research to better understand the causes of cancer in women. In addition, inequalities in primary cancer prevention are more notable in women than in men, which highlights the lack of policies adapted to women's realities.

It is essential promote a new agenda with a gender perspective in oncological care. This agenda must include gender equity in research, fair access to health care, and the integration of gender competency frameworks in the education and training of health personnel. It is also essential to recognize and value the unpaid work of caregivers, and to establish policies that combat gender discrimination at all levels of the health system.

Gender inequalities significantly impact women’s experiences of cancer. To address this, we need to move globally away from a focus on reproductive and maternal health, and for cancer to be considered a priority issue in women’s health. A new feminist agenda for cancer care is called for that eliminates gender inequality, where health systems, cancer workforce and research ecosystems are more inclusive and responsive to the needs of women in all their diversity, thereby reducing the global burden of cancer for all.