Women are underrepresented in clinical trials of non-small cell lung cancer (NSCLC) treatment, according to a meta-analysis presented in a poster at the American Association for Thoracic Surgery (AATS) Annual Meeting.

Women made up less than 40% of participants in NSCLC trials across all regions studied, despite accounting for 50.2% of NSCLC cases worldwide in 2022. 

The meta-analysis included 269 clinical trials of NSCLC treatment published from 2010 through 2020. Of the 124,357 participants in those trials, 38.7% were women. 

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The proportion of female trial participants increased over the period studied, from 36.7% during 2010-2015 to 41.4% during 2016-2020.

Female representation was lower in trials conducted in the United States (46.7%), North America overall (43.3%), Europe (32.1%), Asia (39.0%), and Australia and New Zealand (42.1%). South America had the highest female representation (62.5%), but only 2 studies from the continent were included in the analysis.  

The proportion of female participants was 38.1% in non-surgical NSCLC trials and 43.1% in surgical studies. Female participation was the same for early-stage and late-stage NSCLC trials, at 37.6%. The proportion of female participants was 37.4% in randomized controlled trials and 39.1% in other trials. 

“There is a significant difference in representation between males and females in randomized trials used in defining the treatment patterns of lung cancer,” the researchers wrote in their poster.


Alex G, Krishnan V, Seder C, et al. Representation of women in lung cancer randomized trials – A systematic review. AATS 2023. May 6-9, 2023. Abstract PS62.