title: Under-representation of women in high-impact published clinical cancer research.
abstract: BACKGROUND
  Adequate representation of women in research has been deemed essential.
  
  
  METHODS
  Cancer research published in 8 journals in 2006 was reviewed. The percentage of women among study participants was compared with the proportion expected from population-based estimates of sex-specific cancer incidence, using binomial tests. Differences were assessed in sex distribution of participants by funding source, author sex, and focus of research with the Student t test, and in a linear regression model controlling for cancer type.
  
  
  RESULTS
  A total of 1534 cancer research articles were identified, of which 661 (representing 1,096,098 participants) were prospective clinical studies and were analyzed further. For all 7 non-sex-specific cancer types assessed, the majority of studies analyzed included a lower proportion of women than the proportion of women among patients having cancer of that type in the general population. Among studies focusing on cancer treatment, women constituted a significantly lower overall proportion of the participants in the analyzed studies than expected for 6 of 7 non-sex-specific cancer types (P < .001). Among non-sex-specific studies, the mean percentage of participants who were women was 38.8%. Non-sex-specific studies reporting government funding had a higher percentage of female participants (mean 41.3% vs 36.9%; P = .005). In a regression model controlling for cancer type, lack of government funding (P = .03) and focus on cancer treatment (P = .03) were found to be independent significant predictors of a lower percentage of female participants.
  
  
  CONCLUSIONS
  Women were under-represented as participants in recently published, high-impact studies of non-sex-specific cancers. Studies that received government funding included a higher proportion of female subjects.
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA. rjagsi@med.umich.edu
authors.forename: Reshma
authors.initials: R
authors.lastname: Jagsi
authors.forename: Amy R
authors.initials: AR
authors.lastname: Motomura
authors.forename: Sudha
authors.initials: S
authors.lastname: Amarnath
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Jankovic
authors.forename: Nathan
authors.initials: N
authors.lastname: Sheets
authors.forename: Peter A
authors.initials: PA
authors.lastname: Ubel
mesh_terms: D035843:Biomedical Research / Q000191:economics; D002986:Clinical Trials as Topic; D005260:Female; D005380:Financing, Government; D006801:Humans; D055811:Journal Impact Factor; D008495:Medical Oncology / Q000191:economics / Q000706:statistics & numerical data*; D018579:Patient Selection; D010361:Patients; D010506:Periodicals as Topic; D011446:Prospective Studies; D017678:Sex Distribution; D014930:Women