What is the gender representation in authorship in later phase systemic clinical trials in biliary tract cancer (BTC)? - a retrospective review of the published literature

Mairéad G McNamara; John Bridgewater; Lipika Goyal; Timothy Jacobs; Anna D Wagner; David Goldstein; Rachna Shroff; Markus Moehler; Maeve Lowery; Tanios Bekaii-Saab; Robin K Kelley; Junji Furuse; Lorenza Rimassa; Chigusa Morizane; Angela Lamarca; Richard Hubner; Jennifer Knox; Juan Valle

doi:10.1136/bmjopen-2022-064954

What is the gender representation in authorship in later phase systemic clinical trials in biliary tract cancer (BTC)? - a retrospective review of the published literature

BMJ Open. 2022 Oct 26;12(10):e064954. doi: 10.1136/bmjopen-2022-064954.

Authors

Mairéad G McNamara¹, John Bridgewater², Lipika Goyal³, Timothy Jacobs⁴, Anna D Wagner⁵, David Goldstein⁶, Rachna Shroff⁷, Markus Moehler⁸, Maeve Lowery⁹, Tanios Bekaii-Saab¹⁰, Robin K Kelley¹¹, Junji Furuse¹², Lorenza Rimassa¹³, Chigusa Morizane¹⁴, Angela Lamarca¹⁵, Richard Hubner^{16

15}, Jennifer Knox¹⁷, Juan Valle¹⁶

Affiliations

¹ Department of Medical Oncology, The University of Manchester, Manchester, UK Mairead.McNamara@nhs.net.
² Medical Oncology, UCL Cancer Institute, London, UK.
³ Department of Medical Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA.
⁴ Medical Library, The Christie NHS Foundation Trust, Manchester, UK.
⁵ Department of Medical Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
⁶ Department of Medical Oncology, University of New South Wales, Sydney, New South Wales, Australia.
⁷ Medical Oncology, The University of Arizona Cancer Center-North Campus, Tucson, Arizona, USA.
⁸ Department of Medical Oncology, Universitatsmedizin der Johannes Gutenberg-Universitat Mainz, Mainz, Rheinland-Pfalz, Germany.
⁹ Department of Medical Oncology, TCD, Dublin, Ireland.
¹⁰ Medical Oncology, Mayo Clinic Cancer Center, Scottsdale, AZ, USA.
¹¹ Department of Medical Oncology, University of California San Francisco, San Francisco, California, USA.
¹² Kyorin University Faculty of Medicine, Tokyo, Japan.
¹³ Department of Medical Oncology, Humanitas Cancer Center, Humanitas University, Milan, Italy.
¹⁴ Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
¹⁵ Medical Oncology, The Christie NHS Foundation Trust, Manchester, Manchester, UK.
¹⁶ Department of Medical Oncology, The University of Manchester, Manchester, UK.
¹⁷ Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada.

Abstract

Objectives: Female physicians in medicine are increasing, but disparities in female authorship exist. The aim of this study was to characterise factors associated with female first (FF) and female senior (SF) authorship in later phase systemic oncological clinical trials in biliary tract cancer (BTC) and identify any changes over time.

Setting: Embase/Medline identified trial publications in BTC (2000-2020) were included. χ² tests and log regression were used (assessed factors associated with FF and SF authorship, including changes over time (STATA V.16)).

Primary outcome measure: FF and SF authorship in later phase systemic oncological clinical trials in BTC.

Secondary outcome measure: Any changes over time?

Results: Of 501 publications, 163 met inclusion criteria. The median percentage of female author representation in publications was 25%; there were no female authors in 13% of publications. Geographic location of the home institution of the first and senior authors was Asia (42%/42%), Europe (29%/29%), USA (24%/22%) and other (4%/6%), respectively. Overall, FF and SF author representation was 20% and 10%, respectively. The median position of the first female author was second in all the publication author lists. The phase of trial, journal-impact factor, industry funding or whether the study met its primary endpoint did not impact FF/SF author representation. More SF authors had home institutions in 'other' geographic locations (40% in 10 trials) (p=0.02) versus Asia (6%), Europe (8%) and USA (14%). There were no significant changes in FF/SF representation over time (p=0.61 and p=0.33 respectively).

Conclusions: FF and SF author representation in later phase systemic clinical trial publications in BTC is low and has not changed significantly over time. The underlying reasons for this imbalance need to be better understood and addressed.

Keywords: adult oncology; chemotherapy; hepatobiliary tumours.

MeSH terms

Authorship*
Biliary Tract Neoplasms / therapy
Clinical Trials as Topic*
Europe
Female
Humans
Male
Physicians, Women
Retrospective Studies