Dr. Andrea Simpson and Dr. Nazik Hammad

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Today is International Women’s Day. While this day honours women and the progress that’s been made, work still needs to be done to improve gender equity – including in cancer care.

“Women’s health is often not given the attention that it deserves,” says Dr. Andrea Simpson, obstetrician/gynecologist and endometrial cancer researcher at St. Michael’s Hospital. To help address this, she presented to the House of Commons Standing Committee on Health at the end of last month.

Focusing predominantly on endometrial cancer, Simpson shared with the Committee that the disease has been on the rise in women over the past 10 years, even though it is preventable.

Speaking to the lack of attention on women’s health, she says endometrial cancer’s risk factors (such as obesity and polycystic ovarian syndrome) and signs (such as abnormal uterine bleeding) are often not well-known by the public, negatively impacting prevention.

The lack of funding for hormonal therapies, limited availability of biopsies, and pay disparities for gynecological surgeons also impact equitable access to endometrial cancer care for women.

“Procedures performed on biologically female patients are remunerated more poorly than similar procedures on biologically male patients,” says Simpson.

The four surgeons at St. Michael’s who perform robotic surgery for patients with endometrial cancer: Dr. Andrea Simpson, Dr. Deborah Robertson, Dr. Sari Kives and Dr. Alysha Nensi

Unfortunately, when it comes to cancer, inequities don’t just impact women who are dealing with endometrial cancer. Nor do inequities only impact women as patients.

Dr. Nazik Hammad, oncologist and researcher at St. Michael’s, is part of “Women, power, and cancer,” a Lancet Commission comprised of physicians and experts from all over the world to investigate the link between, as their name suggests, women, power and cancer.

“We think about women as patients only,” says Hammad, referring to how research typically looks at women and cancer. “We wanted to look at it across the continuum and understand how women do in all of these complexities.”

The Commission reviewed existing literature and conducted new research to look at cancer’s interaction with women as patients, participants in prevention, caregivers, health care workers, researchers and policymakers, which they compiled into an extensive report published at the end of last year.

The report highlighted 10 findings, including that 2.3 million yearly deaths by cancer could be diverted if women had better primary prevention, early detection and access to optimal care.

The findings also show women are more likely to experience financial catastrophe due to cancer; women are underrepresented in cancer research, policy-making and as leaders in cancer care; and unpaid caregiving of those with cancer is largely undertaken by women.

“These problems are right there, but they’re hidden because people are not thinking about them,” says Hammad, explaining how these findings have such broad and significant impacts while simultaneously going unaddressed.

For example, she explains that in low-income countries, most women work in informal sectors. While one might not see that as an issue related to cancer, the report discusses that when an individual who works in an informal space gets sick, there is much less financial protection than someone who works in a formal setting.

“So women, in general, will lose more,” she says.

Though the findings in The Lancet Commission might seem bleak, Hammad says knowing them is necessary to make change.

“We need to continue to expose the realities in this asymmetry and then envision a path forward that will transform the way we interact with cancer,” she says.

To help build that future, Hammad and the Commission proposed 10 priority actions that they hope policymakers and leaders in economic and health spaces will implement to address disparities. Actions include ensuring data on sex, gender and socioeconomic demographics is collected and reported in cancer statistics; designing strategies to improve equitable access to care and early detection; and ensuring equitable access to cancer research, leadership and funding opportunities for women.

With issues and actions for change highlighted, Hammad says, “I think there’s a big message of hope.”

Simpson echoes this sentiment, and she took a similar approach as Hammad in her speech at the House of Commons.

Following her presentation of the inequities women experience with endometrial cancer, she suggested four actions for the government to take – including increasing public awareness about the signs and risk factors of endometrial cancer and improving access to hormonal therapies, biopsies and robotic surgeries.

“Through research and advocacy, we are hoping to ensure that women have better and more timely access to the care that they need,” she says. “I always have hope that we can improve.”

By: Kaitlin Jingco