The Inclusion of Women in Studies of Occupational Cancer: A Review of the Epidemiologic Literature From 1991–2009

Abstract

Despite advances in the inclusion of women in studies of occupational cancer, disparities remain in the number of studies of occupational cancer and depth of analysis in studies that included women.

A comprehensive approach of the gender bias in occupational cancer epidemiology: A systematic review of lung cancer studies (2003‐2014)

“…Our results suggest that the inclusion of women in studies regarding occupational lung cancer remains minimal, as shown by the very few women‐only studies and the largely disproportionate men‐to‐women ratio among mixed studies. This observation is consistent with Niedhammer et al and Hohenadel et al studies, in which they found for the broader categories of cancers and respiratory cancers respectively, men to be included in 90.8% and 95.2% of studies (compared to a combined 97.1% of men's inclusion in our study), against 46.1% and 43.2% for women (44.4% in our study) . Two main hypotheses may be formulated while interpreting this men‐centered distribution.…”

“…The type of exposure variable is also of importance, as studies presenting continuous estimates for exposure are likely to produce more precise risk estimates, and further initiate dose‐response analysis. Our sample suggest that mixed studies with higher men‐to‐women ratios were more likely to use continuous estimates; a result in accordance with Hohenadel et al who reported more dose‐response evaluation among studies including men, compared to studies including women‐only.…”

“…Nevertheless, four in ten (non‐nested) case‐control studies were based on men‐only samples studies (data not shown). This hypothesis was also suggested by Hohenadel et al findings. Over 17 cancer types studied, only breast (and female genital) cancer presented more women‐only than men‐only studies.…”

“…For some, the gender difference in PAF simply reflects the lower exposure of women as compared to men, resulting from a sexual division of labor: women are engaged in different and less hazardous jobs or tasks than men . For others, it rather suggests an underestimation of occupational risk factors, as argued by the paucity of information regarding women's exposures . In clinical research, the women's health movement has resulted in attempts to counter sex‐related methodological biases and include more women in studies .…”

“…Previous comparable studies notably include Niedhammer et al who assessed sex consideration in occupational health publications during the year 1997. Also, and more specific to cancers, Zahm et al's survey on the characteristics of occupational cancer studies which included women and minorities between 1971 and 1990; a survey recently updated by Hohenadel et al on women inclusion between 1991 and 2009. In this study, we made the following assumptions: (1) there is a gender gap in the occupational cancer literature and (2) the gap cannot be fully explained by occupational exposure differences or by gender differences in smoking behavior.…”