VCCC Alliance Gender Strategy May 2026
Why do we need a gender strategy? THE GOAL Our goal is to embed gender equity as a core principle within the VCCC Alliance’s strategy and pillars, ensuring that all individuals, regardless of gender, experience fair and equitable cancer care. THE RATIONALE As outlined in the Lancet Commission on Women, Power and Cancer, women, men and people of diverse genders experience cancer differently across the continuum of care. Risk exposure, diagnosis, treatment, survivorship and caregiving are all elements which are experienced differently across genders. Yet cancer systems, including data, services, practices, policies, and leadership, too often reflect a default to a cisgender, binary biomedical model of diagnosis, treatment and care 1. To adequately address these disparities, we need to examine cancer and its outcomes through a gender lens and consequently take action to address these. The VCCC Alliance is a powerful organisation bringing together 12 health services and medical research institutes. The Alliance acknowledges the work to progress gender equity at individual organisations. This gender strategy will amplify and suggest opportunities to collaborate and scale the gender equity already being undertaken by our members. This strategy responds to both a critical moment in cancer reform and a significant shift in the national research and policy environment. From 1 January 2026, The National Health and Medical Research Council (NHMRC) and the Medical Research Future Fund (MRFF) funding applicants will be required to systematically consider sex, gender, variations in sex characteristics and sexual orientation across all stages of health and medical research. This reflects growing recognition that integrating sex and gender analysis is fundamental to highquality, reproducible and equitable research, and essential to improving cancer outcomes for all people in Australia.
1 AWitt A, Legido-Quigley H, Hirst J et al. Sex and gender policies mark a step change for medical research
The Lancet, 405. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02385-2/fulltext
As such, now is a critical moment for the VCCC Alliance to take a more intentional, system-wide approach to gender in cancer. Across the VCCC Alliance, members are already leading important work that addresses gendered differences in cancer research, care, workforce participation and consumer engagement. However, this work is often occurring in pockets, without a shared framework to connect, amplify and scale effective practice. A VCCC Alliance gender strategy provides the mechanism to consolidate this expertise, support members to share learnings, and accelerate the uptake of proven approaches across the cancer system. By embedding a gender lens across all pillars of our work, rather than positioning gender as a standalone equity issue, the Alliance can strengthen impact, improve outcomes and drive more responsive, person-centred cancer care. With its unique convening role, strong consumer pillar, and system-wide reach, the VCCC Alliance is well placed to translate existing momentum into coordinated leadership, enabling members to scale what works and positioning the Alliance as a national leader in genderinformed cancer care and research. Through this strategy, the VCCC Alliance aims to establish itself as a leader in promoting gender equity within the cancer system—advocating for equitable access, outcomes, and representation across all aspects of cancer care and research. A two-phase approach is suggested. Given this is a new area of work for the VCCC Alliance, this could be broadly described as a gender equity focussed approach in Phase 1, and a gendered analysis in Phase 2. Find below illustrative examples of how this strategy may be implemented in practice. It should be noted that execution will be guided by emerging opportunities, with Phase One adopting a more opportunistic and flexible approach.
cancer treatment in existing programs of work
that takes an intersectional approach
that often use cisgender data categories
PHASE 2 Developing inclusive screening materials eg. for trans men, non-binary people and gender diverse people needing cervical screening
Figure 1: Areas of Action Against VCCC Alliance Pillars
consumers to address gender biases that may hinder their advocacy
The evidence Biological sex and gender are major determinants of cancer risk, disease progression, treatment response and survival, yet their influence remains inconsistently addressed across cancer systems. Globally, cancer imposes a comparable overall burden on women, men, and gender-diverse people, with differences reflecting not only biological factors, but also gendered patterns of exposure, prevention, diagnosis, and care 2. Women are more likely to die from sex-specific cancers, particularly breast cancer, while men experience higher mortality from many non-sex-specific cancers, driven in part by behavioural risk factors and later presentation 3. Importantly, fewer cancers affecting women are amenable to primary prevention, and women remain under-represented in research and clinical trials, shaping downstream inequities in evidence, care pathways and outcomes. Together, these dynamics underscore the need for cancer research, policy and practice to systematically integrate sex and gender analysis to achieve more equitable outcomes across the cancer continuum.
Phase 1: Mainstreaming gender equity across the strategic pillars The strategy will adopt a phased approach. Phase 1 focuses on mainstreaming gender equity across the VCCC Alliance strategy through the identification of good practice amongst our members and beyond. It is anticipated this phase will take three years (2026-2029), aligning with the current VCCC Alliance strategy. Mainstreaming gender equity recognises that people of different genders experience health systems differently and requires these differences to be systematically considered in the design, implementation and evaluation of policies, programs and initiatives 4. The VCCC Alliance recognises that, whether explicit or implicit, decision-making within the health sector can perpetuate gender inequities, by overlooking the needs of certain genders or prioritising others.
2 Fink, H., Langselius, O., Vignat, J. et al. Global and regional cancer burden attributable to modifiable risk factors to inform prevention. Nat Med (2026). https://doi.org/10.1038/s41591-026-04219-7 3 Kim HI, Lim H, Moon A. Sex Differences in Cancer: Epidemiology, Genetics and Therapy. Biomol Ther (Seoul). 2018 Jul 1;26(4):335342. doi: 10.4062/biomolther.2018.103. 4 World Health Organization. (2021, May 24). Gender and health. WHO. https://www.who.int/news-room/questionsandanswers/item/gender-and-health
Adopting a gender mainstreaming approach is intended to strengthen the quality, effectiveness and equity of the alliance’s work by ensuring that gender considerations are not treated as an add-on, but as a core component of strategic planning and delivery. This approach has been identified as the most appropriate first step, as it builds on the strong foundation of existing research, tools and practical applications across our members and within the cancer sector 5 more broadly. Leveraging this established evidence base will enable early momentum, support meaningful and measurable impact, and create a robust platform from which to progress broader and more intersectional equity efforts in future phases.
The facts For women, research shows that inequities are deep and multi-layered. Women are more likely than men to face barriers to timely information and participation in decision-making, contributing to delayed diagnoses, misattributed symptoms, and treatment abandonment 6. Financial hardship is also more common among women diagnosed with cancer due to the gender pay gap, informal work, and caregiving responsibilities 7. Globally, caregiving has been feminised, and women have been socialised into nurturing roles which often go unrecognised by family members and by the health care system 8. Unpaid caregiving, when paired with cancer, exerts a substantial toll on the caregiver, demonstrated by a survey which determined that 57% of female unpaid caregivers did not feel supported in their role by governmental organisations, even in high-income countries8. Financial pressures, also referred to as financial toxicity 9 also affect men, but may manifest in a different way. Men in male-dominated industries may face greater financial insecurity following a cancer diagnosis, particularly if the physical nature of their work makes returning to employment difficult after treatment, this is particularly present for men living regionally and rurally6. Additionally, women are significantly under-represented in cancer clinical trials, attributable to being directly or indirectly excluded through trial protocols designed around the male body 10. This underrepresentation extends to their role as participants, lead investigators, or policy influencers. 5 Caring as a social determinant of health. Findings from a rapid review of reviews and analysis of the GP Patient Survey Public Health England, London, UK, 2021 6 World Health Organization. (2022). Global cancer burden growing, amidst mounting need for services. World Health Organization News Release. https://www.who.int/news/item/03-02-2022-global-cancer-burden-growing--amidstmounting-needfor-services 7 Greater Financial Toxicity Relates to Greater Distress and Worse Quality of Life Among Breast and Gynecologic Cancer Survivors - PMC 8 Caring as a social determinant of health. Findings from a rapid review of reviews and analysis of the GP Patient Survey Publi cHealth England, London, UK, 2021 9 Financial toxicity in men undergoing prostate cancer treatment in regional Australia - Masangcay - 2024 - ANZ Journal of Surgery - Wiley Online Library 10 Trials and tribulations: including women in cancer clinical research - The Lancet Haematology
A 2020 review found that women comprised only 38% of trial participants, despite making up half of the cancer population3. Conversely, women make up more than 44% of cancer consumers in Australia, indicating potential bias in the voice of lived experience in cancer program design and practice. In a similar vein, a persistent power imbalance within the health system continues to marginalise the voices of nurses, who are predominantly women, and thus limits their representation in leadership and decision-making roles1. This imbalance constrains their ability to influence the structural organisation of care and, consequently, the potential to mobilise nursing perspectives to address gender inequity is often tightly managed or minimised. While women face multi-layered inequities in cancer care, it is equally important to recognise that men, too, experience unique gendered disadvantages. For instance, societal norms around masculinity, stoicism, and self-reliance discourage many men from engaging in preventive care, seeking help, or sharing their lived experiences. Research consistently shows that men are less likely than women to participate in cancer screening programmes or visit health professionals for early symptoms 11. Additionally, the perceived stigma around vulnerability and illness, particularly for cancers that affect gendered parts of the body (such as prostate, testicular, or breast cancer) can further isolate men emotionally and socially. For example, men diagnosed with breast cancer (which comprises less than 1% of all breast cancer cases) often report feelings of emasculation and exclusion from mainstream breast cancer narratives, which overwhelmingly centre on women 12.
What we can do To recognise the deep-rooted societal and institutional gender dynamics as a reality, the VCCC Alliance must highlight the voices and experiences of women and men in all their diversities across all our program areas and place them at the centre of our research and education: young people, post-menopausal and older women, women and men of different ethnicities, migrant and refugee people, transgender women and men, lesbians, gay and bisexual women/men, people living with HIV or a disability, people who use drugs or incarcerated people.
What does this mean in practice The VCCC Alliance will develop a more intentional approach to the inclusion of gender diversity and equality in our streams of work. This approach does not mean that all streams of work will include a gender aspect, nor that the VCCC Alliance is creating a specific sub strategy on gender. In practice this means that any new or existing areas of activity will be analysed for its potential to include a gendered aspect and apply a gender equity lens.
11 Addressing gender equity in cancer care - Women's Health Victoria 12 Men With a “Woman’s Disease”: Stigmatization of Male Breast Cancer Patients—A Mixed Methods Analysis - PMC
Phase 2: Taking a gendered analysis approach As the VCCC Alliance progresses with programming within its gender strategy, the Alliance will take a gendered approach to all our pillars of work. This means taking into consideration the experiences of all genders in cancer care, recognising the differing social, cultural, and structural determinants that shape access and outcomes for all people. This requires expanding beyond binary gender categories to reflect the lived realities of all people affected by cancer1. Additionally, Phase 2 will involve analysing the gendered aspects of an intervention, through examining the judgements, stereotypes and norms related to masculinity and femininity that occur in the intervention’s context, the systemic barriers that this may produce, and from there, exploring the effect these stereotypes and norms had on the intended intervention outcomes. Through this phase, cancer care can become more inclusive, effective, and equitable for everyone. An overarching goal is for gender equity to be a more intentional component of the next VCCC Alliance strategy. Therefore, the Phase 2 implementation plan will align to the goals of the new VCCC Alliance strategy and will be developed alongside that.
For more information please contact: Sophie ten Dam: sophie.tendam@vcccalliance.org.au Vijaya Joshi: vijaya.joshi@vcccalliance.org.au