Women in Oncology: interview with María José Sánchez Pérez, scientific director of ibs.GRANADA
Women are underrepresented in research leadership positions
Dr. M.ª José Sánchez Pérez is currently a professor at the Andalusian School of Public Health, director of the RGranada Cancer registry and scientific director of Biosanitary Research Institute of Granada (ibs.GRANADA). She finished her MIR specialty in Microbiology at the Virgen de las Nieves University Hospital in Granada in 1996, where she also had the opportunity to complete her doctoral thesis during the Residency period. But she realized that his true vocation was cancer research and since 2009 he has managed to lead a research group of national and international excellence, among other notable responsibilities.
How have you experienced the situation and evolution of gender difference from your time as a student to the present?
I am the youngest of a large family, in which everyone was an academic, but I really liked science and mathematics. Although there was no doctor in my family, I demonstrated great scientific curiosity from a young age, and my family always supported me to dedicate myself first to pure sciences in high school and then to Medicine and research. In my student years, it was common for educational opportunities to be more limited for women, compared to men. In addition, STEM (Science, Technology, Engineering and Mathematics) careers had low female representation. On the other hand, today, there is greater gender parity in education, especially in the field of Health Sciences. Women actively participate in many disciplines, including those that have historically been dominated by men. In addition, there are specific policies and programs to promote equal educational opportunities. In the 80s and 90s, women began to enter the workforce in greater numbers, but they faced significant obstacles such as the wage gap and the glass ceiling. The gender pay gap has decreased, although it has not been completely closed. In conclusion, the gender difference has evolved significantly from my student years to today. Although there is still a lot of work to do to achieve full equality, the progress is undeniable and reflects a positive change in society.
Have gender differences marked your professional development in any way? Did you experience greater differences in the university, clinical or research field?
Well, I think not too much, unlike what has happened to other women around me. I have been fortunate to have had two excellent mentors, one in the field of Microbiology and another in the field of Oncology and Cancer Epidemiology, who have taught me, guided me professionally, and have been my role models. I believe that my mentors have been fundamental in my professional development. Furthermore, I have never put limits on my aspirations or the opportunities that have been presented to me. Perhaps my own attitude, my desire, my ability to adapt and resilience may have played an important role in overcoming the challenges that I have encountered in my professional life. On the other hand, I have worked in different institutions with progressive policies regarding gender equality, which have provided me with a supportive environment. Where I have been able to encounter some difficulties and barriers due to gender differences, it has been with the reconciliation of professional and personal life, reconciling the academic and scientific career with family responsibilities. To advance in the research career, you have to dedicate many hours of work, which logically have to be subtracted from your personal life and family. I am aware that there are many things in life that I have missed.
The field of Microbiology and Epidemiology and Public Health, especially in the field of research, have traditionally been where there have been more men than women and are where you have developed your professional career. What has been your experience? ? What difficulties did you have to face?
Yes, there are gender inequalities in women who carry out research in Epidemiology and Public Health, as well as in other fields of Science and Medicine. The lack of female role models and mentors could limit women's aspirations and opportunities. Clearly women are underrepresented in leadership positions in research. Although there are many women researchers, few reach high-level positions such as department heads, directors of research institutes, as is my case, or editors in important scientific journals. On the other hand, research indicates that women publish fewer articles than their male colleagues and that their work receives fewer citations. Additionally, women are less likely to be lead authors or corresponding authors of articles in high-impact journals.
Women are also less likely to receive large research grants compared to men. Some studies have shown that funding applications submitted by women are approved less frequently and, when approved, receive less funding. Female researchers also face inequalities in terms of recognition and awards. Fewer women receive prestigious awards and other recognition for their work compared to their male peers. Finally, caregiving responsibilities, which still fall disproportionately on women, can limit the time and energy we can devote to our research work.
If I make a personal assessment, I think that, like almost all women researchers, I have had to face some difficulties, above all, I have had to make a greater effort to demonstrate my professional worth and I have had to see research evaluation committees made up only of men, and when you complained, they told you that there were no women who could occupy those leadership positions. I would also like to highlight that these inequalities not only affect individual researchers, but also have a negative impact on general scientific progress, since the diversity of perspectives and approaches is crucial for research, innovation and advancement in the field. of cancer, and in other disciplines. And, although gender barriers are decreasing, it is essential to continue working to eliminate these differences and promote equality in all areas of scientific and medical research between men and women.
In the research teams, which profile is the majority? Are the obstacles that women have to face less than when you started?
There is currently a more balanced gender representation in research groups. Women are increasingly present at all levels, although the “gender scissors” effect continues to be observed (there are more women at initial and mid-career levels, but as the category rises, the number of women participating in the research career is increasingly fewer), with few women still in leadership, senior and highly responsible positions. This means that the classrooms and laboratories are full of women and the offices, committees and boards of directors are full of men. Women researchers now have more visibility and recognition, which is undoubtedly helping to inspire more women to enter and remain in the world of Health Sciences research.
You have also been in charge of some teams. What has been your experience? Do you think he has had more difficulties than other male professionals?
Since 2009 I have directed the Granada Cancer Registry, one of the oldest Spanish population cancer registries and with the longest tradition of conducting research in epidemiology, prevention and control of cancer. I followed the legacy of Dr. Carmen Martinez, a medical oncologist who created and directed this Registry at the Andalusian School of Public Health from 1985 to 2008, when she retired. I guess that made things easier for me, it was a natural and organized relief, she was a great woman with great professional recognition at the national and international level. Since 2009 I also assumed the leadership of a research group on Cancer Epidemiology, Prevention and Control, of which I am very proud and which has been growing over the years. It is made up of researchers from the Andalusian School of Public Health, the Biosanitary Research Institute (IBS), of Granada, which I currently direct, the CIBER of Epidemiology and Public Health and the University of Granada with a multidisciplinary profile (oncology, cancer epidemiology , statistics, health economics, nutrition, environmental epidemiology, public health and psychology). On the other hand, since 2020 I have been the scientific director of the Biosanitary Research Institute (ibs.GRANADA) of Granada, accredited by the Carlos III Health Institute. I am the only scientific director of the four accredited Andalusian institutes. Here I not only direct my research group, but I also have the responsibility of directing more than 1000 healthcare and university researchers in Granada, and of setting the scientific strategy of the Institute. It is a lot of work, but at the same time, a very rewarding experience.
What encouraged you to dedicate yourself to research? Did she encounter difficulties in doing so?
Since I was a child I was always a very curious person. I liked to study and I was interested in everything. My older sister, who I have been with for ten years, remembers that, when she was very little, when she was studying, I would sit next to her and tell her, "She studies out loud, that's how I learn." I'm doctor. I finished my MIR specialty in Microbiology at the Virgen de las Nieves University Hospital in Granada in 1996, where I also had the opportunity to complete my doctoral thesis during the Residency period. Although I really liked clinical practice and infectious diseases, I got a research scholarship in an international project on Human Papillomavirus and oral cavity cancer at the Andalusian School of Public Health. Joining a project of these characteristics allowed me to participate in all phases of the research process (study design, field work, statistical analysis and scientific articles). It was a difficult professional situation to assume, I was a doctor, a specialist and a doctor, and I found myself without an employment contract, with a research scholarship from the Carlos III Health Institute. Nobody understood it, because as an Area Specialist Physician, I earned much more money and it seemed more in line with my professional career. But I liked what I did, so I continued my training in Cancer Epidemiology and Clinical Research and I realized that my true calling was cancer research. Working in an international multidisciplinary research group opened many doors for me in the field of research and since 2009 I have been leading a research group of national and international excellence. It hasn't been easy, but Devoting yourself to research requires a lot of effort and hours of dedication, but I confess that I am passionate about what I do and I enjoy working to prevent cancer and help people with cancer.
Do you think there is still a long way to go in reconciling work-family? What are the measures that should be implemented?
Yes, although significant progress has been made in work-life balance, there is still a long way to go and various measures need to be implemented and improved to address persistent challenges. Women still shoulder a disproportionate share of caregiving and domestic chores responsibilities, which can limit their availability and career advancement. On the other hand, the lack of flexibility in work schedules can make work-life balance difficult, especially in positions that require prolonged physical presence or continuous availability. I believe that flexible working policies, adequate parental leave, childcare services and a supportive organizational culture are essential to achieve true work-life balance and allow both men and women to balance their work and family responsibilities effectively. Institutions and companies that adopt these measures will surely be better positioned to attract and retain talent and promote an inclusive and more equitable work environment. Also Mentoring programs in science, technology and innovation should be established, with a gender focus. To achieve equality in the 21st century, effective measures must be established that guarantee family and work conciliation, encouraging the equitable distribution of care for children and the elderly, and of household chores. In addition, controls are needed to prevent salaries for male researchers that are higher than those of female researchers and a male bias in the selection of positions of responsibility. Also, merit evaluations must reward the effort involved in making science and motherhood compatible, so that being a researcher and mother adds up, and does not mean competing at a disadvantage.
On some occasions she has said that "working in an international multidisciplinary research group opened many doors for me in the field of research and since 2009 I have been leading a research group of national and international excellence." Has that been the step that has most marked her career?
Without a doubt, leading a research group and bringing it to scientific excellence is the step that has most marked my scientific career. Working as a team and collaboratively with other international and national research groups, and being integrated into the highest research structures of this country, the Networked Biomedical Research Centers (CIBER) and the Biohealth Research Institutes, is undoubtedly a guarantee of success that allows you to grow more as a research group. Now my responsibility is to mentor the most emerging researchers and give space to the most senior researchers, so that they can lead their own lines of research.
She has recently obtained first place in Andalusia and thirteenth position nationally in the second edition of the Ranking of Spanish and foreign researchers working in Spain, published by the Higher Center for Scientific Research (CSIC). How do you value it?
This has happened after almost 30 years of hard work, enthusiasm and dedication. Previously in 2018, I was included in the list of Highly Cited Researchers, being one of the most cited researchers in the world. Staying there is very difficult and it is only possible if you really like what you do, after many years of intense work, and having an excellent research group behind you. Science needs women role models and leaders. I feel pride and satisfaction, but I have to recognize that this recognition is not only mine, but also that of the research group that I am fortunate to lead and the institutions that I represent: the Andalusian School of Public Health, the Biosanitary Research Institute of Granada ( ibs.GRANADA) and the CIBER of Epidemiology and Public Health (CIBERESP). I insist that it is nothing more than a reflection of the multidisciplinary work of the researchers who work with me, or better, I with them. And I hope this recognition serves to awaken and encourage new scientific vocations among girls and young people, because We need women without limits for the science of the future.
How would you like your time in research to be remembered? What aspects would she highlight, especially her?
For me it is very important that the research we do is transferred and reaches clinical practice, public policies, and society, if not, what we do has no meaning. For this reason, I dedicate more and more time to scientific dissemination and telling what we do to patients and citizens, in general. The World Health Organization estimates that approximately 40% of all cancers could be prevented if the population maintained healthy lifestyles (not smoking, not drinking alcohol, healthy diet, physical exercise,...). My goal therefore is cancer prevention, because I believe it is the most cost-effective long-term strategy for this disease. On the other hand, I want to leave a better future for girls and women who want to dedicate themselves to research in Biomedicine. More and more women are dedicated to scientific research, but there remains a deep gender gap in positions of responsibility in this sector. Although the percentage of female researchers in Spain rises to 42% -according to the latest report from the Ministry of Science-, only a quarter of decision-making positions are represented by women. I am sure that there will not be a better future if we do not add the talent of women to research.
What lines of work do you plan to develop soon?
We are currently beginning to develop two new lines of research: One on the influence of the biological effects of stress, measured through allostatic load (reflects the accumulated physiological burden of chronic stress experienced by the body over time, reflected in biomarkers of the neuroendocrine, immune and cardiometabolic systems), in cancer risk and survival. We believe that allostatic load could be a promising biomarker used in personalized prevention and early detection of cancer. And, another, about the assessment of exposure to mixtures of heavy metals, microplastics and other persistent pollutants with the risk of developing cancer, taking into account genetic susceptibility. On the other hand, we continue with the recent line of research on socioeconomic inequalities in the epidemiological indicators of cancer (incidence, prevalence and survival) and how greater adherence to clinical practice guidelines influences the survival of people with cancer.
What advances in the world of Oncology would you like to experience? What priority lines should we bet on, in your opinion?
The answer is easy. Logically, I would like to be able to experience the cure for all types of cancer and, above all, the cure for childhood cancer. My scientific dream is that no more boys or girls die with cancer. Cancer is an important Public Health problem, with high morbidity and mortality. According to data from the International Agency for Research on Cancer, overall the number of new cancer cases is increasing. There are few cancers, for which a decrease in the number of new cancer cases is observed, such as lung or larynx cancer in men, due to the decrease in the prevalence of tobacco consumption in men in the population. The opposite of what we observe in women, in whom tobacco-related cancers are increasing. Cancer is a disease that increases as age increases and since the population is older (people's life expectancy has increased), we are seeing more cases of cancer. However, we know that this is not the only contributing factor and that an increased risk of developing cancer, the incidence, is observed due to other causes. But of course, Cancer is not a single disease, but a group of diseasesThere are between 150-200 types of cancer. And cancer is a multifactorial disease, between 5-10% of cases are due to genetic causes and between 90-95% to causes such as tobacco, alcohol, obesity, sedentary lifestyle, unhealthy diet, infections, sun exposure, etc.
On the other hand, there is an increasing prevalence of cancer, not only because more new cases of cancer are diagnosed, but also because people who have been diagnosed with cancer live longer, so not only the incidence has increased, but also the survival of cancer. Given this scenario, in my opinion the priority lines of research that should be pursued are: cancer prevention, both primary prevention, early detection and secondary prevention, long-term cancer survivors, personalized medicine (from prevention to diagnosis and treatment) and cancer in young people (20-49 years).
