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

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.