# Gender equity and career progression among Croatian oncology professionals compared with the ESMO global survey

## TL;DR

A survey of Croatian oncology professionals reveals gender and work-life balance issues as major barriers to career progression, with findings similar to global trends.

## Contribution

This study provides a national perspective on gender equity in Croatian oncology, highlighting unique local challenges and comparisons with global data.

## Key findings

- Gender was reported to affect career progression in 40% of cases, more than political affiliation.
- Poor work-life balance was the top barrier, cited by 69% of respondents.
- Administrative overload and long working hours were common, with 59% feeling overwhelmed.

## Abstract

Based on the 2016 and 2021 ESMO Women for Oncology (W4O) surveys, which revealed persistent gender disparities in oncology, we conducted a national survey to examine career-related challenges among oncology professionals in Croatia and compare them with international trends.

We administered an anonymous online survey adapted from the 2021 ESMO W4O questionnaire, contextualized for the Croatian setting. The survey explored the perceived impact of gender, political affiliation, religion, and sexual orientation on career development. Responses were analyzed by gender and age.

A total of 206 participants responded (74% women, 26% men), primarily medical and radiation oncologists (55%), followed by pathologists (15%) and surgical oncologists (5%). Among all respondents, 41% were aged ≤ 40, 18% were residents, and 43% had worked in oncology for less than 10 years. Most worked in university (42%) or general hospitals (39%). Gender was reported to moderately or significantly affect career progression in 40% of cases—more frequently than political affiliation (22%)—while religion and sexual orientation had minimal influence. Major gender-related barriers included poor work–life balance (69%), societal pressure (46%), unconscious bias (44%), and limited leadership opportunities for women (33%). Workplace gender-based discrimination was reported by 36%, and 38% had experienced or witnessed harassment; however, only 11% reported incidents. Although 80% valued career advancement, 34% were dissatisfied with their progression. Overall, 86% faced career barriers, primarily poor work–life balance (56%), lack of mentors (42%), and demotivating work environments (36%). Administrative overload was widespread: 59% felt overwhelmed, and 61% worked more than 8 h daily.

Gender remains a substantial barrier to career advancement in oncology. Systemic interventions are needed to address work–life imbalance, discrimination, and structural burdens to support equity and sustainable career development.

The online version contains supplementary material available at 10.1186/s12913-025-13870-8.

Croatian survey confirms poor work-life balance is the top barrier to oncology career progress.

Nearly 60% say administrative overload limits leadership roles and academic career growth.

Career dissatisfaction higher in Croatian oncologists, especially those aged 40 or younger.

Gender (40%) and political views (22%) remain key barriers, impacting women and young professionals.

Stronger support for gender quotas and reforms shows need for tailored national strategies.

The online version contains supplementary material available at 10.1186/s12913-025-13870-8.