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Disaggregating Gender Inequality Globally: Health Systems, Gender Inequality, and Female Pan-Cancer Outcomes
Asher J Shin1, Shivaek Venkateswaran1,2, Yue Helen Zhang1
1Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY.
JCO Global Oncology
|July 9, 2026
Summary
Gender inequality, especially concerning reproductive health, education, and political representation, is linked to worse female cancer outcomes globally. Addressing these inequalities is crucial for improving women's cancer survival rates.
Area of Science:
- Global Health
- Cancer Epidemiology
- Gender Studies
Background:
- Gender inequality significantly impacts women's health, including cancer outcomes.
- Social, economic, and health system factors contribute to disparities in cancer.
- The Gender Inequality Index (GII) offers a framework to analyze these disparities.
Purpose of the Study:
- To disaggregate the Gender Inequality Index (GII).
- To identify specific dimensions of gender inequality influencing global female cancer outcomes.
- To assess the independent impact of reproductive health, education, workforce, and political empowerment on cancer mortality-to-incidence ratios (MIR).
Main Methods:
- Ecologic, cross-national analysis of data from 185 countries.
- Utilized age-standardized female cancer mortality-to-incidence ratios (MIR) from GLOBOCAN 2022.
- Employed univariable and multivariable linear regressions, adjusting for health system indicators (UHC, GDP, workforce, health spending, radiotherapy access).
Main Results:
- Univariable analysis revealed associations between GII components and higher MIR.
- Multivariable models identified higher adolescent birth rates, lower female secondary education, and lower women's parliamentary representation as independently linked to higher female MIR.
- Fully adjusted models showed higher Universal Health Coverage (UHC) index and Gross Domestic Product (GDP) per capita predicted lower MIR, while adolescent birth rate showed a potential positive association.
Conclusions:
- Structural gender inequalities in reproductive health, education, and political representation are associated with poorer female cancer outcomes.
- Improving cancer outcomes globally requires advancing gender equity.
- Key strategies include enhancing reproductive health access, promoting girls' education, and increasing women's leadership.
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