Examining global and gender disparities in high-impact evidence synthesis on lung cancer: A 2000-2024 analysis of Cochrane Library.

Abstract

e23021 Background: Most cancer-related deaths occur in low-middle-income countries (LMICs), yet LMICs are underrepresented in global oncology research. Women have also historically been underrepresented in clinical literature. High-impact evidence synthesis influences guidelines and practice worldwide, so equitable authorship can ensure that issues presented are applicable globally. The Cochrane Library is a repository of high-impact systematic reviews that can be authored from all over the world. So, we aimed to analyze the representation of LMICs and women in the authorship of lung-cancer-related Cochrane Reviews. Methods: From the topic 'Lung and Airways' in the Cochrane Library, we included all studies related to lung cancer, published till February 2, 2024. We extracted the authors’ national affiliations, categorizing them into LMICs and non-LMICs based on the 2023 World Bank income classifications. Collaboratives/ groups were considered as a single entity. Following this, we manually captured at least one webpage for each author showing their gender or gender pronouns. For authors whose gender could not be determined via manual search, we used Gender-API, an artificial intelligence-based software, to determine their gender based on their name and country. Authors with < 90% certainty of gender on Gender-API were categorized as unknown. Results: We included 42 reviews that had 233 authors, including three group authors. United Kingdom (22.32%; n = 52/233), followed by Australia (16.31%; n = 38/233), Spain (13.3%; n = 31/233), China (9.01%; n = 21/233) and France (6.87%; n = 16/233) were the most represented countries. There were no authors from LMICs. Manually, we ascertained gender for 85.04% (n = 194/228) of authors, and overall, for 94.74% (n = 216/228). Women constituted 42.6% (n = 92/216) of all authors. They were, however, better represented as first authors (50%; n = 19/38) and corresponding authors (54.05%; n = 20/37). Conclusions: Despite suffering the brunt of cancer, LMICs had no representation in lung-cancer-related Cochrane reviews. While authorship had a male preponderance overall, women were well represented as first and corresponding authors. Addressing authorship disparities in global oncology literature, via mentorship and capacity building, can improve its applicability and utilization.