Abstract
All children with cancer deserve equal and equitable access to care and appropriate treatment, irrespective of gender, class, and geographical location. However, girls with cancer might be at a disadvantage to boys with cancer in parts of the world such as India, in which there is a disproportionately higher registration of cancer cases in boys than girls (sex ratio of 1·58:1). 1 Bhopal SS Mann KD Pearce MS Registration of cancer in girls remains lower than expected in countries with low/middle incomes and low female education rates. Br J Cancer. 2012; 107: 183-188 Crossref PubMed Scopus (12) Google Scholar The challenge of equity, however, begins even before children develop cancer. Starting at birth, large numbers of sex-selective abortions in some parts of India lead to skewed gender ratios in the general population. 2 Saikia N Meh C Ram U et al. Trends in missing females at birth in India from 1981 to 2016: analyses of 2·1 million birth histories in nationally representative surveys. Lancet Glob Health. 2021; 9: e813-e821 Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar The biases against girls in India are often firmly entrenched in the sociocultural milieu, and extend to multiple aspects of health care. 3 Khera R Jain S Lodha R Ramakrishnan S Gender bias in child care and child health: global patterns. Arch Dis Child. 2014; 99: 369-374 Crossref PubMed Scopus (68) Google Scholar Consequently, there is a gender differential in infant and under-5 mortality. 4 Chowdhury R Taneja S Mazumder S Bhandari N Strand TA Gender differences in infant survival: a secondary data analysis in rural North India. BMJ Open. 2017; 7e014179 Google Scholar , 5 Patel P Kumar K Singh M Yadav AK Sex differentials in under five mortality in India in last two decades: evidence from pooled NFHS data. Child Youth Serv Rev. 2020; 118105286 Google Scholar Sex disparity in childhood cancer in India: a multi-centre, individual patient data analysisThe sex ratio for childhood cancer in India has a bias towards boys at the level of diagnosis, which is more pronounced in northern India and in situations demanding greater financial commitment. Addressing societal sex bias and enhancing affordable health care for girls should be pursued simultaneously in India. Full-Text PDF
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