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Background: While the global workforce is approaching gender parity, women occupy a small number of management level positions across most professions, including healthcare. Although the inclusion of women into the membership of many oncology societies has increased, the under-representation of women in leadership roles within international and national oncology societies remains relatively consistent. Moreover, the exact status of women participating as board members or presidents of oncology societies or as speakers at oncology congresses was undocumented to date., Methods: The database used in this analysis was derived from data collection performed by the European Society for Medical Oncology for the years 2015-2016 and data analyses performed using the Statistical Analysis Software V.9.3 and R language for statistical computing V.3.4.0 by Frontier Science Foundation-Hellas. The literature search was performed by the authors., Results: We report the presence of a gender gap within oncology. Results regarding the under-representation of women occupying leadership roles in oncology show female participation as members of the board or presidents of national and international oncology societies and as invited speakers at oncology congresses remains below 50% in the majority of societies included in this analysis. Women in leadership positions of societies was associated with a higher percentage of female invited speakers at these societies' congresses (p=0.006)., Conclusion: The full contribution that can be attained from using the potential of women in leadership roles is currently under-realised. Examples of how gender and minority participation in organisations improves outcomes and creativity are provided from science, clinical practice and industry that show outcomes are greatly improved by collective participation of both men and women. Although there are programmes in place in many oncology organisations to improve this disparity, the gender gap is still there. Ongoing discussion may help to create more awareness in the effort to accelerate the advancement of women within oncology., Competing Interests: Competing interests: EH-T is an employee of Janssen, the Pharmaceutical Company of Johnson & Johnson Europe, and a shareholder of Johnson & Johnson. DA has received research funding and/or honoraria from Roche, Merck Serono, Bayer Healthcare, Servier, BTG, Terumo, Sanofi Oncology, Eli Lilly and has participated in non-financial roles as ECCO Executive Board member, ECCO Oncopolicy Group member, EORTC Task Force member (Gastrointestinal cancers)—Global PI function with MOLOGEN, IMPALA trial (MGN 1703 as investigative agent). GC has received research funding and/or honoraria from Roche, Novartis, Pfizer and has participated in non-financial roles as a member of Steering Committee in clinical trials, member of data safety monitoring committee for clinical trials. EG has participated as Advisor for Roche, Neomed Therapeutics and Ellypses Pharma. MCG has received research funding and/or honoraria from MSD, BMS, Roche Astra Zeneca, Takeda and Eli Lilly. CR has been a consultant for BMS, Roche, Novartis, Pierre Fabre, MDS and Amgen. CS is a Scientific Consultant for SAKK (Swiss group for cancer research treatment) and has participated in non-financial roles as the ESGO Vice President, Principal Investigator for the Icon 8B Study, EUPATI Switzerland. SP has received research funding and/or honoraria from Genentech/Roche, Pfizer, Eli Lilly, MSD, Merck Serono, BMS, Novartis, Astra Zeneca, Boehringer Ingelheim, Amgen, Clovis, Regeneron, Janssen, Takeda and has participated in non-financial roles on the IASLC Board of Directors 2014–2017, SAKK lung group Vice-president, SAMO Vice-president, Froome Past President (2011–2017), ETOP Foundation Council/Scientific coordinator, ESMO president elect 2010–2021, PI ALEX trial, Genentech Steering committee, PI academic trials ETOP, EORTC/SAKK, FMH, IASLC, AACR.

Background: Although women account for a growing proportion of the oncology workforce, there is evidence they are under-represented in leadership roles. To gain further insights into this issue and extend understanding of gender challenges, the European Society for Medical Oncology Women for Oncology (W4O) Committee undertook a survey of female and male oncologists in 2016., Design: The 2016 W4O questionnaire included questions on (1) Demographics and professional environment, (2) Gender impact on career development, (3) Challenges for career progression and inappropriate behaviour experienced in the workplace, (4) Barriers for gender parity and (5) The gender gap. Between July and September 2016, the online survey was available to male and female clinical and academic oncology healthcare professionals in the EU and internationally., Results: Responses were analysed from 462 oncologists, of whom 76.7 % were women. Of female respondents, 45.5 % had a managerial or leadership role, compared with 65 % of male respondents (p<0.001). Men were more likely to have leadership roles, even in clinical teams with more women than men. Women respondents were more likely to consider their gender had a major impact on their career than men: 35.9 % vs 20.9 % (p<0.001). The biggest challenge to career progression for women was work and family balance (64.2%). Of female respondents, 14.4 % believed there had been significant or major progress in closing the gender pay gap compared with 39.3 % of men (p<0.001). Of female participants, 37.7 % reported they had encountered unwanted sexual comments by a superior or colleague., Conclusions: New initiatives are needed to address under-representation of women oncologists in leadership roles, including greater and concrete promotion of work-life balance, development and leadership training for women, and more support for flexible working. The fact that over a third of women in the survey had encountered unwanted sexual comments at work is of great concern and must be urgently addressed., Competing Interests: Competing interests: DA has received research funding and/or honoraria from Roche, Merck Serono, Bayer Healthcare, Servier, BTG, Terumo, Sanofi Oncology, Eli Lilly and has participated in non-financial roles as ECCO Executive Board member, ECCO Oncopolicy Group member, EORTC Task Force member (Gastrointestinal cancers)—Global PI function with MOLOGEN, IMPALA trial (MGN 1703 as investigative agent). GC has received research funding and/or honoraria from Roche, Novartis, Pfizer and has participated in non-financial roles as a member of Steering Committee in clinical trials, member of data safety monitoring committee for clinical trials. MCG has received research funding and/or honoraria from MSD, BMS, Roche Astra Zeneca, Takeda and Eli Lilly. EG has participated as Advisor for Roche, Neomed Therapeutics and Ellypses Pharma. EH-T is an employee of Janssen, the Pharmaceutical Company of Johnson & Johnson Europe, and a shareholder of Johnson & Johnson. CR has been a consultant for BMS, Riche, Novartis, Pierre Fabre, MDS and Amgen. CS is a Scientific Consultant for SAKK (Swiss group for cancer research treatment) and has participated in non-financial roles as the ESGO Vice President, Principal Investigator for the Icon 8B Study, EUPATI Switzerland. SP has received research funding and/or honoraria from Genentech/Roche, Pfizer, Eli Lilly, MSD, Merck Serono, BMS, Novartis, Astra Zeneca, Boehringer Ingelheim, Amgen, Clovis, Regeneron, Janssen, Takeda and has participated in non-financial roles on the IASLC Board of Directors 2014–2017, SAKK lung group Vice-president, SAMO Vice-president, Froome Past President (2011–2017), ETOP Foundation Council/Scientific coordinator, ESMO president elect 2010–2021, PI ALEX trial, Genentech Steering committee, PI academic trials ETOP, EORTC/SAKK, FMH, IASLC, AACR.