Gender equity and career progression among Croatian oncology professionals compared with the ESMO global survey

BACKGROUND: Based on the 2016 and 2021 ESMO Women for Oncology (W4O) surveys, which revealed persistent gender disparities in oncology, we conducted a national survey to examine career-related challenges among oncology professionals in Croatia and compare them with international trends. METHODS: We administered an anonymous online survey adapted from the 2021 ESMO W4O questionnaire, contextualized for the Croatian setting. The survey explored the perceived impact of gender, political affiliation, religion, and sexual orientation on career development. Responses were analyzed by gender and age. RESULTS: A total of 206 participants responded (74% women, 26% men), primarily medical and radiation oncologists (55%), followed by pathologists (15%) and surgical oncologists (5%). Among all respondents, 41% were aged ≤ 40, 18% were residents, and 43% had worked in oncology for less than 10 years. Most worked in university (42%) or general hospitals (39%). Gender was reported to moderately or significantly affect career progression in 40% of cases—more frequently than political affiliation (22%)—while religion and sexual orientation had minimal influence. Major gender-related barriers included poor work–life balance (69%), societal pressure (46%), unconscious bias (44%), and limited leadership opportunities for women (33%). Workplace gender-based discrimination was reported by 36%, and 38% had experienced or witnessed harassment; however, only 11% reported incidents. Although 80% valued career advancement, 34% were dissatisfied with their progression. Overall, 86% faced career barriers, primarily poor work–life balance (56%), lack of mentors (42%), and demotivating work environments (36%). Administrative overload was widespread: 59% felt overwhelmed, and 61% worked more than 8 h daily. CONCLUSIONS: Gender remains a substantial barrier to career advancement in oncology. Systemic interventions are needed to address work–life imbalance, discrimination, and structural burdens to support equity and sustainable career development.