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There is a great consensus about how masculinized science is. Documented and researched primarily by (and for) men, women scientists have been a minority pushed into the shadows. And the patients too. There are many diagnoses designed for the physiology of men or treatments according to their symptoms. But this is nothing new. About thirty Researchers from four continents have wanted to go further and ask what happens when other variables such as gender, ethnicity or social class are added to sex discrimination. Intersectionality is a transversal term in the Lancet study, Woman, power and cancer, published in September. María Teresa Bourlon, oncologist and author of the multidisciplinary commission in charge, is blunt in conversation with América Futura: “Cancer is still closely linked to patriarchy. And patriarchy has many other nuances that are increasingly entering scientific research. There is no point in continuing to ignore them.”
The study shows some very hard figures. At least 1.5 million women’s deaths could be avoided through primary prevention or early detection strategies, and another 800,000 if all women had access to optimal cancer care. That is, the death of 2.3 million people per year could be avoided. These correspond to almost half of the annual cancer deaths in women (4.43 million). This, for the Mexican co-author, has a lot to do with the lack of a gender perspective in public prevention, diagnosis and treatment policies, which is rooted in the lack of reliable national data on access to healthcare or assistance to treatments. “When there are no figures, the question of why women are not reaching health posts, why they are not following treatment or why they do not have a support network to take care of them is not usually asked. Knowing these contexts and having reliable and rigorous data is very important.”
The first barrier, the economic one
This interdisciplinary group of The Lancet He asked himself all these questions. And they reached a profound conclusion: gender gaps – economic, care and violence – are major obstacles in the fight against cancer. The first barrier is economic. “They continue to be the main ones in charge of housework and those who work do not usually do so formally. Thus, many do not even have access to health services,” says Bourlon. This translates into later diagnoses, she adds. “Women, especially from more disadvantaged backgrounds, have less reaction capacity and economic resources to face treatments. And this is not usually captured in cancer studies,” she says. Almost two out of ten women arrive for consultations when the disease is very advanced or practically unstoppable. After breast cancer, lung cancer is the most common among women despite the fact that in the collective imagination it continues to be linked to a “male disease”: “The only cancers that are different and require a different approach are those linked to male and female biology. And yet, they are not studied equally.”
Another problem that Bourlon points out is the fear of sexual abuse in consultation. Many women have been victims of touching and even rape during medical appointments. “There are a large number of male healthcare workers and many patients stop going after hearing these types of testimonies from family or friends,” she says. A flagrant case is her discovery of the high number of incomplete colonoscopies – an examination that allows direct visualization of the intestine to detect, among others, colon cancer – in women, compared to men. “It’s not anecdotal, it happens a lot.” Likewise, this research delves into cultural barriers and the lack of health education in mainly rural areas. “Latin America is very diverse and there are many myths around chemotherapy or radiology that have to be debunked. Only in this way can medicine arrive,” she points out. In countries with a low human development index, 72% of cancer deaths are premature. A percentage that is almost halved in countries with medium and high incomes.
Caring women who are not cared for
Caregiving is the third major disadvantage of women also in the healthcare field. Although they are the ones who organize to weave networks of support and care for sick partners, parents or children, when they are the patients, this community of care does not seem to be as solid. “On the one hand, they often have to leave precarious jobs to care. But almost no one takes care of them. That is why they do not usually complete treatments or do not continue monitoring symptoms,” explains the expert. The main proposal of the authors of the study is also one of the great requests of the feminist movements: that care be paid. In Mexico, for example, this economic sector could represent up to 2% of national health spending.
Not making a change of outlook can even open the gaps more, since the tendency is for this type of pathologies to increase over the years. In 2020, 9.23 million women worldwide were diagnosed with cancer and 4.43 million died from the disease. By 2040, these are expected to reach 13.3 million new cases and 7.1 million deaths, which would represent a 44% increase in new cases and a 60% increase in deaths. “We have to start by talking about the gender perspective. It is urgent,” asks Bourlon.
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