A comprehensive approach of the gender bias in occupational cancer epidemiology: A systematic review of lung cancer studies (2003-2014)

Abstract

Background: In occupational epidemiology, a male-centered perspective often predominates. We aimed to describe current research practices in terms of gender consideration at different stages of epidemiological studies.

Methods: A systematic review of occupational lung cancer publications indexed in PubMed was conducted over the period 2003-2014. Articles were described according to the sex composition of their study sample.

Results: In 243 studies, 7 (3%) were women-only, 101 (41%) were mixed, with a disproportionate men-to-women ratio (P50 = 3.5; P75 = 12.4). A shift was observed from mixed and unspecified source populations to men-only final samples. Our results also suggest implicit generalization of results from men-only studies, a lack of tests of interaction and often unjustified sex-adjustment for mixed studies.

Conclusions: The lower proportion of women in studies cannot be fully explained by their under-representation in the target populations, since there were large numbers of women among both potentially exposed workers and patients diagnosed with lung cancer.

Keywords: bias (epidemiology); carcinogens; lung neoplasm; occupational exposure; women; women's health.