Studies in Cancer Epigenetics through a Sex and Gendered Lens: A Comprehensive Scoping Review

SIMPLE SUMMARY: This study aimed to assess how well sex and gender data was used in the field of cancer epigenetics. The researchers conducted a thorough review of 111 scientific studies focusing on colorectal, gastric, head and neck, hepatocellular carcinoma, and lung cancers. They found that only a small proportion (15.3%) explicitly analyzed sex and gender as a primary objective. While the majority (92.8%) provided some analysis of sex and gender as biological or social variables, only a few studies (6.3%) explicitly defined the terms “sex” and “gender”. Additionally, many studies (75.7%) incorrectly used these terms interchangeably, and there was inconsistency in their usage in 39.6% of the studies. In conclusion, the researchers emphasize the need for clear guidelines on incorporating sex and gender as variables in epigenetics research. ABSTRACT: Background: Sex and gender are vitally important in the study of epigenetic mechanisms for various types of cancer. However, little has been done to assess the state of sex and gender-based analyses (SGBA) in this field. The aim was to undertake a critical evaluation of sex and gender representation, discussion, and data analysis within the cancer epigenetics field since 2010. Methods: A PRISMA-ScR scoping review was conducted with 111 peer-reviewed studies comprising of colorectal, gastric, head and neck, hepatocellular carcinoma, and lung cancers. Data extraction and a quality appraisal were performed by a team of epidemiologists and bioethicists. Results: Of the 111 included studies, only 17 studies (15.3%) explicitly stated sex and gender analysis to be their primary aim. A total of 103 studies (92.8%) provided a detailed analysis of sex/gender as a biological or social variable, while the remaining 8 studies (7.2%) only stratified results by sex/gender. Although sex and gender were a key facet in all the eligible studies, only 7 studies (6.3%) provided an explicit definition of the terms “sex” or “gender”, while the remaining 104 studies (93.7%) used the words “sex” or “gender” without providing a definition. A total of 84 studies (75.7%) conflated the concepts of “sex” and “gender”, while 44 studies (39.6%) were inconsistent with their usage of the “sex” and “gender” terms. Conclusions: Very few studies offered a robust analysis of sex/gender data according to SAGER guidelines. We call for clear and directed guidelines regarding the use of sex/gender as a variable in epigenetics research.