Gender inequality in genitourinary malignancies clinical trials leadership

Abstract

Background Over the past 2 decades, there has been a growing interest in the signifcance of gender roles in healthcare and several eforts and initiatives have focused on increasing female representation in the medical feld. Clinical trials play a very important role in shaping medical practice; moreover, the leaders of clinical trials often represent the upper echelon of researchers in any designated feld. Presently, there is no data regarding women’s representation in urological oncology clinical trials leadership. Therefore, the aim of this study is to examine the extent of female representation in leading urological clinical trials. Methodology To thoroughly examine the representation of females as principal investigators (PIs) in urological cancer clinical trials between 2000 and 2020, we conducted a comprehensive search of completed trials focused on kidney, prostate, and bladder cancer on ClinicalTrials.gov. We extracted relevant information regarding the PIs and analyzed the data using univariate analyses to identify any signifcant diferences between male and female PIs. Results A total of 9145 cancer clinical trials were conducted over the last 2 decades, and 11.3% (n=1033) of them were urological cancer clinical trials. We were able to obtain detailed information about the principal investigators (PI) in 79.0% (n=816) of the clinical trials, and we found that 16.8% (n=137) of them were led by female investigators. Upon evaluating the characteristics of the PIs, female PIs had a signifcantly lower median age and median total citations as compared to male PIs (55.0 vs 59.0 and 5333 vs 7902; p-value<0.001 and 0.006, respectively). However, there was no statistically signifcant diference between the termination rate, publication rate, funding source, cancer type, and the subject of conducting the clinical trials between male and female PIs. Conclusion Between 2000 and 2020, only 16.8% of urological cancer clinical trials were led by a female PI, perhaps refective of a low percentage of senior female researchers in the felds of urology, oncology and radiation oncology. Universities, research institutes and funding agencies should work to improve mentorship, representation and opportunities for female investigators to encourage more involvement for female researchers in these clinical trials.