Gender disparities in academic radiation oncology research: A narrative review

Despite rising numbers of women in radiation oncology (RO), they remain under-represented in academic leadership and research. This narrative review assesses gender disparities in academic RO.

PubMed/MEDLINE and Europe PMC were searched in August 2026 for articles published from 2000 onwards, with additional domain-specific and country-specific searches. Of 1629 records, 1035 were screened on title and abstract after removal of duplicates and preprints, 657 were assessed in detail, and 108 that reported primary, gender-disaggregated data on radiation oncologists or trainees were included, together with three authorship analyses that report the radiation oncology journals separately. Because outcome definitions and academic structures differ across countries, the synthesis is narrative.

The "leaky pipeline" was a consistent finding: women hold a smaller share of senior posts than of the workforce in every country with data. Across United States National Cancer Institute-designated centres, 24.6% of men versus 15.5% of women held full professorships (p = 0.001), and women were 11.8% of chairs at those centres. Women held 18.9% of full professorships in Germany in 2024. Crude bibliometric differences were attenuated or abolished by stratification for rank. Men were 76% of 340 National Institutes of Health-funded RO principal investigators, and women were twice as likely as men to treat breast malignancies (risk ratio 2.01, 95% CI 1.75-2.50). In France, 65% of female respondents perceived gender as a career barrier. Coverage is uneven: 82 of 108 studies are North American, none from Africa.

Disparities persist across countries. The evidence is observational and cannot establish mechanisms; corrective programmes report outcomes, none controlled. Differences are associations, not causal effects; no data were identified for Africa, the Middle East, Eastern Europe or most of Asia. A national survey with SFRO, SFjRO and FORce is needed.