Closing the gender gap in the authorship of hematology/oncology-related randomized controlled trials requires inclusive effort from male and female senior researchers

Abstract Importance: Severe gender gap in academic research output is pervasive across all medical specialties, including hematology and oncology. Objective: This bibliometric study aimed to investigate the representation of females in premier first and last authorship positions of hematology- and oncology-related randomized controlled trials (RCTs) published between 2000–2022. Additionally, we investigated the trend of females in first authorship positions with a male or female senior author. Design: Bibliometric analysis of clinically oriented hematology and oncology RCTs published between 2000 and 2022 across all PubMed-indexed journals. Participants: First and last authors of 5,891 hematology- and oncology-related RCTs. Main Outcomes: Change in the proportion of female first and senior authors and the proportion of RCTs with the same and cross-gender dyads of first and senior authors. Results: 5,891 RCTs were available with identifiable gender of first and senior authors. A total of 49 countries and 62 journals were represented in our study sample. The proportion of females in our study population was 22.9% (n = 1,349) in the first authorship and 17.5% (n = 1,032) in the senior authorship positions and were predominantly affiliated with institutions in high-income countries (94.1%, n = 1,270 and 95.3%, n = 984). We also noted a significant upward trend in the percentage of female authors in the first authorship position (16.3% in 2000 to 32.4% in 2022, p = 0.001) between 2000 and 2022; the trend was stronger with male than female senior authors. However, the odds of the females in the first authorship position with a female senior author were significantly higher only when both authors came from high-income countries [OR = 1.702 (95%CI 1.461–1.984; p < 0.0001]. The proportion of female senior authors remained stable during the study period. Conclusions and Relevance: Despite early trends in closing the gender gap in the authorship of hematology- and oncology-related RCTs, females remain severely underrepresented in premier authorship positions. The increasing proportion of female authors in the first authorship position with a male senior author indicated that a more inclusive effort to train, mentor, and encourage young female physician-scientists with the involvement of senior male and female researchers will likely accelerate the overall increase in female authorship.