{
  "abstract": "Why did you do this work? Previous research has suggested that under-diagnosis of female cases in low- and middle-income countries may contribute to the known global male predominance of childhood cancer cases. 1 This study aimed to investigate associations between childhood cancer sex ratios and global economic and gender equality indexes.What did you do? Age standardised rate (ASR) childhood cancer sex ratios were calculated using data collated from, at the time, the most recent Cancer Incidence in 5 Continents report, Volume XI. 2 Data on economic, development and gender inequality, including sex ratio data on literacy and school attainment, were collated from the World Bank and World Economic Forum. Linear regression was used to evaluate potential associations, with adjustments made for geographical region and GDP as potential confounders. Additionally, we calculated the odds of differing countries having their cancer data included in the registry, therefore assessing the potential bias.What did you find? The odds of having cancer registry data included in the study varied with all included variables, all suggesting increasing odds of being included with increasing development and gender equality. A significant association was found with the ASR childhood cancer sex ratio and the literacy sex ratio (Coeff -0.75, 95% CI -1.51, -0.007, p=0.048), with very similar results seen when excluding sex specific cancers and lymphomas. A non-linear association (p=0.018) was also found between the percentage of parliamentary seats held by women and the ASR cancer sex ratio. For both these results, the more empowered girls and women were, the more equal the cancer sex ratio.What does it mean? It remains likely that cultural and economic factors are leading to under-diagnosis of female childhood cancers. The lack of associations with non sex-ratio markers of development suggests that this issue goes beyond a country’s income level, being more about the treatment of young females. Consequently, global cancer registry data should continue to be interpreted with the knowledge that female cases may be under-reported. There is also a need for good quality cancer registries in all countries.References Bhopal, et al. Registration of cancer in girls remains lower than expected in countries with low/middle incomes and low female education rates. 2012.Bray, et al. Cancer incidence in five continents Volume XI. 2021",
  "authors": [
    {
      "affiliations": [
        "Northumbria Healthcare"
      ],
      "name": "Joseph Munno"
    },
    {
      "affiliations": [
        "Newcastle University"
      ],
      "name": "Mark Pearce"
    }
  ],
  "title": "8080 Female childhood cancer registrations, compared to males, are lower in countries with less equal female to male literacy ratios",
  "uid": "47f38e94-83a7-5667-b058-da0ca63ff5f2"
}