There is a lack of diversity in leadership at US cancer centers, according to a survey published in the Journal of the National Cancer Institute.

The survey revealed that most leadership positions are held by non-Hispanic White individuals, and women are underrepresented across leadership roles.  

The survey included 82 cancer centers, 64 of which were National Cancer Institute centers. The researchers looked at diversity among 82 center directors, 62 deputy directors, 639 associate directors, and 795 research program leaders.

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Across the different roles, most positions were filled by non-Hispanic White individuals (72% to 82%), although Asian/Pacific Islander individuals were overrepresented as well (10% to 19%).

Underrepresented racial and ethnic groups included Hispanic (3% to 7%), non-Hispanic Black (0% to 6%), American Indian/Alaska Native (0% to 0.2%), and other or mixed race (1% to 3%) individuals.

There was an underrepresentation of women and nonbinary people as well. Women made up 16% of directors, 31% of deputy directors, 45% of associate directors, and 39% of research program leaders. None of the centers reported having leaders who were nonbinary.

RoleAmerican Indian/ Alaska NativeAsian/ Pacific IslanderHispanicNon-Hispanic BlackNon-Hispanic WhiteOther/ Mixed RaceMenWomen
Director (n=82)0%9.8%7.3%2.4%79.3%1.2%84.2%15.9%
Deputy Director (n=62)0%11.3%3.2%0%82.3%3.2%69.4%30.7%
Associate Director (n=639)0.2%13.3%6.1%5.8%72.3%2.3%55.4%44.6%
Research Program Leader (n=795)0%18.7%4.5%1.5%72.1%2.4%60.9%39.1%
Race, ethnicity, and gender of leaders at cancer centers.

The researchers postulated that the observed lack of diversity is likely due to multiple factors, but “bias may play a key role.” For example, individuals from underrepresented groups “tend to hold roles such as directors of community outreach and engagement that may be perceived as less competitive within the traditional pathway to becoming a cancer center director,” the researchers wrote.

The lack of diversity may also be a result of the underrepresentation of racial/ethnic minorities, women, and gender minorities in health care overall. In particular, the underrepresentation of racial/ethnic minorities may be attributed to “disparities in the application, matriculation, and completion of professional and graduate school among these individuals,” the researchers wrote.

The researchers also outlined strategies to promote diversity in cancer center leadership. They wrote that promoting diversity in leadership “begins by enhancing the diversity of the cancer center membership itself, continues with an equitable search process to create a diverse pool of candidates, and is followed by deliberate and inclusive processes of onboarding, integration, and leadership development.”


Lerman C, Hughes-Halbert C, Falcone M, et al. Leadership diversity and development in the nation’s cancer centers. J Natl Cancer Inst. Published online July 28, 2022. doi:10.1093/jnci/djac121

This article originally appeared on Cancer Therapy Advisor