Persistent gender gaps in health: major global differences in cancer care for women

Significant differences in health between men and women persist. Increasingly, research is being conducted into women-specific conditions, including certain types of cancer. The largest analysis ever conducted on the care of women with breast, cervical, and ovarian cancer shows major global differences in stage at diagnosis, treatment, and adherence to international guidelines. The study, recently published in The Lancet, includes data from more than 275,000 women across 39 countries between 2015 and 2018. Sabine Siesling, lead researcher in the Breast Cancer team at IKNL and Professor of “Personalised Cancer Care” at the University of Twente (TechMed Centre), is a co-author of the article in The Lancet.

Key Findings:

1. In high-income countries, 40% of cancers were detected at an early stage, compared to less than 20% in low- and middle-income countries (LMICs).
2. Ovarian cancer is the least likely to be diagnosed early worldwide (less than 20%).
3. Three-quarters (78%) of women in high-income countries and more than half (56%) of women in LMICs were offered surgery, but international clinical guidelines were not consistently followed globally.
4. Across all three cancer types, older women were less likely to receive guideline-adherent treatment compared to younger women, both in high-income countries and LMICs.
5. In most LMICs, and again for all three cancer types, women faced longer waiting times for surgery after diagnosis.

THE IMPORTANCE OF CONSISTENT CARE

For cancers that occur specifically in women (breast, cervical, and ovarian), there are major global disparities in stage at diagnosis and in treatment. Factors such as socioeconomic status, education level, distance to treatment centres, and availability of facilities like radiotherapy play a crucial role in determining the type of care women receive. This is also true in countries with well-developed healthcare systems, where policy and insurance structures sometimes influence access to optimal treatment.

This study powerfully illustrates that care for women with cancer does not always align with international guidelines. Because we have a strong infrastructure and reliable data from the Dutch Cancer Registry (NKR), we can contribute to these international studies and learn from global differences to further improve our own care.

THE NETHERLANDS AS BOTH EXAMPLE AND LEARNER

The study shows that both stages of diagnosis and adherence to guidelines vary widely. Siesling explains: “Although data sources differ in completeness and quality across countries, we clearly see major differences in early diagnosis and adherence to international treatment guidelines. International collaboration and comparison help us understand where we stand and where improvements can be made. The effects of screening programs can be compared. By continuing to share data and learn from other countries, we can better tailor care to each woman, with optimal, personalised care as the goal.”

This research exemplifies how the University of Twente contributes to improving women’s health through the Technology for Women’s Health initiative.

About the study

The VENUSCANCER study, led by Prof. Dr. Claudia Allemani (London School of Hygiene & Tropical Medicine), is the first large-scale global analysis of care for three of the most common cancers in women. The study is part of the CONCORD program, which monitors worldwide cancer survival and care quality.

ABOUT THE DUTCH CANCER REGISTRY (NKR)

Data from the Dutch Cancer Registry (NKR) on cancer survival—by cancer type, province, age group, and sex—are available on NKR Cijfers. The NKR is a national database containing reliable data on all cancer patients in the Netherlands and is managed by Integraal Kankercentrum Nederland (IKNL). The data are used for scientific research on cancer and its treatment, contributing to better therapies and improved care for people living with cancer. These insights help continually enhance cancer care for current and future patients.