Gender bias in shared decision-making among cancer care guidelines - A systematic review

Q: What was the main objective of the systematic review?

To systematically analyze recommendations about shared decision-making in clinical practice guidelines and consensus statements for the most frequent male-only (prostate) and female-only (endometrial) cancers.

Q: Which databases and sources were searched, and was there a language restriction?

The protocol was registered in PROSPERO and searches covered MEDLINE, EMBASE, Web of Science, Scopus, and guideline databases and professional society websites; searches were performed independently by two reviewers with no language restrictions.

Q: What key gender-related difference was found between prostate and endometrial cancer guidelines?

Shared decision-making was recommended more often in prostate cancer guidelines than in endometrial cancer guidelines, and adherence to the shared-decision-making 31-item tool was lower for endometrial guidance.

Sep 24, 2026

Uploaded by Oliver

Background: In cancer care, shared decision-making promoted in clinical practice guidelines (CPGs) and consensus statements may differ by gender. Objective: Systematically analyze recommendations on shared decision-making in CPGs and consensus statements for prostate and endometrial cancer. Search strategy: PROSPERO-registered protocol; MEDLINE, EMBASE, Web of Science, Scopus and guideline databases plus society websites, no language restrictions. Findings: 176 documents; SDM more often recommended for prostate than endometrial cancer, with lower compliance for endometrial guidance.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages20

Reading Time50 min

AccessFree to download

Abstract

Background and Objective

Search Strategy

Inclusion Criteria and Data Synthesis

Main Results

Discussion and Conclusions

Introduction

DOI: 10.1111/hex.13753 REV I EW ART I CLE Gender bias in shared decision‐making among cancer care guidelines: A systematic review Mario Rivera‐Izquierdo PhD, Associate Lecturer1,2,3 | Marta Maes‐Carballo PhD, Associate Lecturer1,4,5 | José J. Jiménez‐Moleón PhD, Professor1,3,6 | Virginia Martínez‐Ruiz PhD, Lecturer1,3,6 | Jan Blaakær MSc, Professor7 | Rocío Olmedo‐Requena PhD, Lecturer1,3,6 | Khalid S. Khan MSc, Professor1,3,6 | Jan S. Jørgensen PhD, Professor7 1Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, Spain 2Service of Preventive Medicine, Hospital Universitario San Cecilio, Granada, Spain 3Instituto de Investigación Biosanitaria de Granada (ibs.Granada), Granada, Spain 4Academic Department of General Surgery, Complexo Hospitalario de Ourense, Ourense, Spain 5Academic Department of General Surgery, Hospital Público de Verín, Verín, Spain 6Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España 7Research Unit of Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics, Institute of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark Correspondence Mario Rivera‐Izquierdo, Department of Preventive Medicine and Public Health, Universidad de Granada, Avenida de la Investigación 11, 18016 Granada, Spain. [Email:](Email: mariorivera@ugr.es)[ mariorivera@ugr.es](Email: mariorivera@ugr.es) Abstract Background: In cancer care, the promotion and implementation of shared decision‐ making in clinical practice guidelines (CPG) and consensus statements may have potential differences by gender. Objective: To systematically analyse recommendations concerning shared decision‐ making in CPGs and consensus statements for the most frequent cancers exclusively among males (prostate) and females (endometrial) . Search Strategy: We prospectively registered the protocol at PROSPERO (ID: RD42021241127) . MEDLINE, EMBASE, Web of Science, Scopus and online sources (8 guideline databases and 65 professional society websites) were searched independently by two reviewers, without language restrictions. Inclusion Criteria: CPGs and consensus statements about the diagnosis or treatment of prostate and endometrial cancers were included from January 2015 to August 2021. Data Extraction and Synthesis: Quality assessment deployed a previously developed 31‐item tool and differences between the two cancers analysed. Main Results: A total of 176 documents met inclusion criteria, 97 for prostate cancer (84 CPGs and 13 consensus statements) and 79 for endometrial cancer (67 CPGsand 12 consensus statements) . Shared decision‐making was recommended more often in prostate cancer guidelines compared to endometrial cancer (46/97 vs. 13/ 79, 47 .4% vs. 16. 5%; p < .001) . Compared to prostate cancer guidelines (mean 2 .14 items, standard deviation 3.45), compliance with the shared‐decision‐making 31‐item tool was lower for endometrial cancer guidelines (mean 0.48 items, standard deviation 1 .29) (p < .001) . Regarding advice on the implementation of shared decision‐making, it was only reported in 3 (3.8%) endometrial cancer guidelines and in 16 (16 . 5%) prostate cancer guidelines (p < .001) . This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2023 The Authors. Health Expectations published by John Wiley & Sons Ltd. Discussion and Conclusions: We observed a significant gender bias as shared decision‐making was systematically more often recommended in the prostate compared to endometrial cancer guidelines. These findings should encourage new CPGs and consensus statements to consider shared decision‐making for improving cancer care regardless of the gender affected. Patient or Public Contribution: The findings may inform future recomme

FAQs

What was the main objective of the systematic review?

To systematically analyze recommendations about shared decision-making in clinical practice guidelines and consensus statements for the most frequent male-only (prostate) and female-only (endometrial) cancers.

Which databases and sources were searched, and was there a language restriction?

The protocol was registered in PROSPERO and searches covered MEDLINE, EMBASE, Web of Science, Scopus, and guideline databases and professional society websites; searches were performed independently by two reviewers with no language restrictions.

What key gender-related difference was found between prostate and endometrial cancer guidelines?

Shared decision-making was recommended more often in prostate cancer guidelines than in endometrial cancer guidelines, and adherence to the shared-decision-making 31-item tool was lower for endometrial guidance.

Sep 24, 2026

Uploaded by Oliver