Girls lose out to boys in cancer treatment

Girls lose to boys in the fight against cancer – for every two boys, only one girl was treated at Tata Memorial Hospital (TMH) in Mumbai, the largest cancer hospital in India.

This gender gap hampers the treatment of childhood cancer in girls, oncologists say, and calls for action to address a range of issues from prejudice and awareness to even financial aid.

TMH records viewed by The Indian Express show that during the 10-year period between 2011 and 2021, a total of 18,394 children from across India received treatment at TMH Hospital. Of these, no less than 11,962 or 65% were boys, the remaining 6,432 were girls, accounting for 35% of the total number of children.

These figures tell a wider national story given that out of the total number of pediatric patients, only 30% come from Maharashtra, the rest from other states.

Even at Homi Bhabha Cancer Hospital in Varanasi, the second largest pediatric oncology center among TMCs – it runs eight in total – the gender gap is significant. In 2019, of the 325 pediatric cancer patients, 197 or 60% were boys and in 2020, of the 392 patients, 250 or 63% were boys.

At TMH, Mumbai, over the past 10 years, the total number of boys is almost double that of girls who came for treatment at the hospital – the gap of more than 75% every year except 2018 where the number of boys was only 24 percent. hundred more than that of the girls. (See table)

In comparison, the gender gap narrows in the adult population. According to available data, in 2017, out of the total 34,906 cancer cases among the adult population who came to TMH, Mumbai, 57% were male and in 2018, out of the 36,095 adult cancer cases, 58 % were men.

This discrepancy is concerning given that the most common childhood cancers do not discriminate on the basis of gender.

According to Dr. Girish Chinnaswamy, a pediatric oncologist at TMH: “Cancers of the mouth, breast or prostate are minimal in children. Mostly we see blood cancers or cancers of the bones, lungs, brain, among others, which affect both genders equally. »

He attributed the discrepancy to the possibility that “compared to boys, girls are less likely to be referred for diagnosis.”

Moreover, since early detection and prompt treatment lead to the cure of almost 80% of pediatric cases, oncologists have stated that girls who are not treated for cancer lose their chances of survival and have a life. normal like other children.

An illustrative example is that of a one-year-old girl from Latur who was diagnosed with leukemia – blood cancer – in 2021 and was undergoing treatment in hospital. On March 7, 2021, however, her father had her released and brought her to their home village. When social volunteers contacted him, he refused to continue treatment and the girl died within weeks.

“The family already had another daughter, citing the example of her future, they refused to return to Mumbai for the treatment of the patient,” said Shalini Jatia, ImPaCCT Foundation Secretary, Pediatric Oncology, TMC.

“Nobody says it directly. They beat around the bush and then subtly deliver the message – a girl’s life is worth less,” she added.

The gender gap in detection and treatment in India contrasts sharply with that of developed economies where it is 1:1.

Dr. SD Banavali, Director of the eight Tata Memorial Centers (TMCs) in India and Professor of Medicine and Pediatrics at TMH, said: “The skewed sex ratio in cancer detection can be attributed to the social attitude where girls with cancer are not a priority for treatment. They don’t even go to hospitals for treatment, so cases of cancer in girls go unreported.

Banavali added: “Although the situation has improved, in cases of eye and kidney cancer, where we have to harvest the organs, the parents refuse to do so citing that their daughters will not marry. A similar attribute is seen when we suggest amputations to save lives.

“The sex ratio in cancer detection is more skewed in northern parts of India. A study by AIIMS showed that the boy to girl ratio was 5 to 1,” Dr Banavali said.

The gender gap is also reflected in the “treatment refusal and default” (TRA) rate when it comes to girls. The rate of TRA among boys in 2019 at TMH, Mumbai was 2.3% compared to 2.7% among girls.

Of the 20 girls who dropped out of treatment, eight of the cases were due to gender-based disparity.

In 2020, the ART rate was 3.2% in boys compared to 4.6% in girls. Of the 19 girls who dropped out of school, in eight cases the reason was gender discrimination. However, last year was an exception when the ART was higher for boys (1.9%) than for girls (1.7%).

Often, even after obtaining money for the girls’ treatment, the parents withdraw. Anita Peter, executive director of the Cancer Patients Aid Association, said parents often refuse to upload photos of girls with cancer to crowdfunding portals to raise money for treatment.

“They fear that if their relatives or neighbors find out there is cancer, their daughters will not marry. So they refuse any financial help even if it costs the lives of their daughters,” she said.

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