CHICAGO – On its last full day, the American Society of Clinical Oncology (ASCO) annual meeting continued to feature abstracts related less to drug development than to social issues, as lead study author Marina Stasenko, of the Memorial Sloan Kettering Cancer Center in New York, offered details of a survey that found 64% of gynecological oncologists experienced sexual harassment in training or practice. Among women, the rate was 71% and among men 51%, but only 10% reported their incidents to officials. Women were more likely than men to respond that gender affected career advancement (34% vs. 10%) and played a role in setting their salary (42% vs. 6%).

Earlier, ASCO highlighted several abstracts dealing with socioeconomic factors that lead to inequity in health care access, and Stasenko's survey squarely took aim at a medical practice problem that has been making major headlines in other contexts. The study was designed to measure perceived gender biases, the prevalence of sexual harassment in training as well as the workplace, and the impact of gender and harassment on career growth and advancement. Stasenko modeled the effort in part on an Association of American Medical Colleges survey on the topic that has been conducted since 2012. The anonymous questionnaire was sent in October 2018 to all 1,566 U.S.-based Society of Gynecologic Oncology members who were physicians. Of the recipients, 402 (26%) replied; 255 replies were from women and 147 were from men. (See BioWorld, June 4, 2019.)

Respondents gave various reasons for not reporting the incidents. Some thought the incident(s) did not seem important enough (40%) or that nothing would be done about it (37%), and others feared retaliation (34%). The most frequent forms of sexual harassment experienced by those in training or practice, respectively, were: being subjected to sexist remarks (58/51% of women and 28/24% of men); being denied opportunities for training (26/33% of women and 17/19% of men); unwanted sexual advances (30/23% of women and 27/28% of men); and being asked to exchange sexual favors for academic positions (4% of women and 2% of men, equally in training and practice).

Thirty-one percent of women and 14% of men said they received lower evaluations or academic positions as a result of harassment. Thirty-four percent of women believed that gender had affected their career advancement, compared with 10% of men. Forty-two percent of women stated that gender played a role in setting their salary, compared with 6% of men. With regard to pay, 57% of women perceived a gender-related gap, compared with 9% of men.

"I think it's important that we have these conversations," ASCO expert Merry-Jennifer Markham said, calling the survey helpful "as it gives us more data to show us where the problems are."

Some, though, found problems with the survey itself. With a nod to the 26% response rate, Stasenko allowed that selection bias was "absolutely" a potential hitch in the findings. At the same time, she said, "our response [rate] is either on par or even better than most studies of this nature." She pointed to a poll of gynecological laparoscopy personnel that gained a response rate of only 16%.

Her project "came about from general conversations I've had with colleagues, and various anecdotes that we shared." Gynecological oncology is "a very women-forward field," she noted. "If this is what's going on in our field, where women make up such a large proportion of the population, I certainly think it can be applicable to other areas of medicine." And surveys asking "somewhat similar questions in other fields" have turned up similar results, she said.

With regard to the low reporting rate of sexual harassment incidents, Stasenko said that more than 20% of "folks didn't know who to report to, or how to report." Also, more than 90% of respondents "knew that there was a policy in their institution, but only about 60% knew what the policy was," a situation that she said could be "vastly improved upon." Asked about the large number of men claiming harassment, she said researchers were "very surprised. Who is doing the harassment [of men] is an excellent question. Hindsight is 20/20, and I wish we had included [that item] in the questionnaire." Participants, though, "really have a hard time with long surveys. I could probably do another five or six studies looking at the different factors" influencing responders, she said.

Last year a report from the National Academies of Sciences, Engineering, and Medicine called for "a system-wide change to the culture and climate in higher education to prevent and effectively respond to sexual harassment," saying there is "no evidence" that current policies and procedures have resulted in a significant reduction. The report examined sexual harassment of women in academic sciences, engineering and medicine, and urged institutions to consider sexual harassment equally important as research misconduct in terms of its effect on the integrity of research.

In a survey the University of Texas system conducted among its graduate and undergraduate students, about 20% of female science students, more than a quarter of female engineering students, and more than 40% of female medical students experienced sexual harassment from faculty or staff. The Pennsylvania State University system conducted a similar survey and found that 33% of its female undergraduates and 43% of its female graduate students (in all disciplines) experienced sexual harassment from faculty or staff; so did 50% of female medical students.

The ASCO meeting ended Tuesday.