Written Evidence Submitted by Cancer Research UK

(DIV0098)

Key Points

• Diversity in STEM (Science, Technology, Engineering & Mathematics) is crucial to cancer research. 1 in 2 people will get cancer in their lifetime[i], but evidence shows some groups in society are hit harder than others. We need a diverse and inclusive research community who can accelerate progress against cancer. By drawing on a wide range of ideas from a variety of backgrounds, a diverse research community will maximise scientific innovation and creativity for the benefit of all cancer patients.

• The lack of diversity in academia continues to be an issue. For example, in 2017/18, just 3% of the 15,560 UK-funded PhD students were Black[ii]. At the senior level, there are only 85 Black professors within UK higher education institutions[iii]. This lack of diversity in the scientific workforce is a global problem – grant applications submitted to the US National Institutes of Health by White Principal Investigators (PIs) are 1.7 times more likely to be funded than those submitted by Black PIs[iv].

• A lack of consistency in approaches to Equality, Diversity & Inclusion (EDI), data collection and evidence gathering of what is effective means it is hard to assess impact and progress on interventions, to compare methods and outcomes between organisations, and to make clear recommendations about emerging good practice. A robust evidence base is essential for identifying barriers to individuals participating and thriving in cancer research. It is also important to ensure the most effective actions are taken across the ecosystem to improve equality, diversity and inclusion in research.

• As a major research funder, Cancer Research UK (CRUK) wants to lead by example, to use our influence and work collaboratively to make cancer research funding available to all the best researchers. CRUK has put strategies in place to tackle inequalities in cancer through the research we fund, including by embedding EDI considerations in CRUK-funded cancer trials and proactively driving a research ecosystem that generates evidence in cancer inequalities. Tackling inequalities in all its forms is critical to achieving CRUK’s mission to beat cancer.

• We are committed to ensuring we apply our EDI agenda to our science funding and research activities – this includes reviewing and improving our own funding processes, policies and culture. CRUK was one of the UK’s first charity research funders to publish diversity data in our grant funding[v]. Consistent with sector wide data on STEM roles, our data shows underrepresentation of groups, including women and ethnic minorities. For example, CRUK sees an underrepresentation of Black researchers across all applications, and we see fewer applications from female researchers at senior levels.

• CRUK agrees with the conclusions set out in the report[vi] by the APPG on Diversity & Inclusion in STEM’s inquiry into Equity in the STEM Workforce. This includes recognition of a lack of consistent data and consensus on solutions, the need for Government to take a multi-pronged approach to drive equity as well as the impact COVID-19 has had on exacerbating inequalities. The trajectory set in the UK Government’s R&D People & Culture Strategy to diversify routes into R&D and STEM is welcome. It is vital further action is taken by Government and the wider research ecosystem to build on this foundation.

1. What are the implications of groups such as women, ethnic minorities, people with disabilities and those from disadvantaged socioeconomic backgrounds being underrepresented in STEM roles in academia and industry?

CRUK’s ambition in achieving its vision of beating cancer relies on a diverse and inclusive scientific workforce. By drawing on a wide range of ideas from a variety of backgrounds, a diverse research community will be able to maximise scientific innovation and creativity for the benefit of all cancer patients. In order to drive scientific progress, it is essential that all researchers, regardless of their backgrounds, are attracted to, retained and working in, cancer research.

Underrepresentation in STEM roles in academia and industry has a number of implications. For example, underrepresentation will affect the diversity of scientific ideas that are put forward for grant funding, which ideas receive funding and their relevance to research priorities as determined by health needs of diverse populations. Without diverse researchers being attracted to science, engaged in scientific training through undergraduate and postgraduate degrees, and ultimately becoming the next generation of researchers, we will miss out on novel, diverse new ideas being brought to cancer research.

It is also important to acknowledge the impact underrepresentation in STEM roles has on who participates in research and healthcare access. For example, in the US ethnic minorities are significantly underrepresented as clinical investigators[vii], and in turn, this drastically impacts the number of ethnic minority participants[viii]. Minority participants often cite a lack of trust of researchers as a reason why they do not participate in clinical research. To overcome this, minority participants want to believe that the researchers have their and their community's best interests at heart and that researchers are honest and transparent about the interventions[ix].

Representation of underserved groups in studies or cancer trials may impact generalisability of findings and efficacy of novel drugs treatments, particularly in relation to sex and ethnicity. For example:

• a study[x] across four chemotherapy trials for esophagogastric cancer found 16.7% of female patients experience serious side effects compared with 9.5% of male patients, highlighting the importance of sex-disaggregated analysis and associated additional research to ensure appropriate treatment regimens for population groups;
• in the US, Black people are often insufficiently represented in clinical trials of new drugs[xi], even when the treatment is aimed at a type of cancer that affects them more, for example prostate cancer. 

The lack of diversity through the academic pipeline also impacts the future STEM workforce. As an example of underrepresentation in academia, just 3% of the 15,560 UK PhD students in 2017/2018 were Black[xii]. The statistics are even less encouraging for senior career stages, with figures from Advance HE showing there are only 85 Black professors within UK higher education institutions[xiii] (4.6% of all Black faculty, compared with 11.2% of White faculty who hold this position). The picture is worse when disaggregated by gender; only 25 UK Black professors are women[xiv].

2. What has been done to address underrepresentation of particular groups in STEM roles?

CRUK published its EDI strategy in 2021[xv] making a public commitment to change for the better and holding ourselves accountable for our progress. Our vision is to create a charity where everyone feels like they belong, benefits from, and participates in, the work we do. CRUK is committed to ensuring we apply our EDI agenda to our science funding and research activities – both by reviewing and improving our own funding processes, policies and culture and by using our role as a major research funder to encourage our research community to develop an equal, diverse and inclusive research culture where all researchers can reach their potential.

As a research funder, people are at the heart of the research we fund – the researchers and their teams who are delivering the highest quality of research – and this underpins everything CRUK does. CRUK relies on the sharpest minds to help us beat cancer, and it is incumbent on us – together with other funders, research institutions and individual researchers – to create diverse and inclusive research environments which allow all brilliant minds to come together, thrive and progress.

There are many reports examining inequality in the STEM workforce across protected characteristics. However, according to UK Research and Innovation (UKRI)’s recent evidence review on EDI[xvi], there continues to be a lack of evidence on interventions beyond gender (or sex) equality or ‘general’ EDI, such as diversity training – and the report stated it was difficult to measure the effectiveness of interventions. This report outlined that successful interventions tended to involve collaboration across an organisation; have commitment from senior management; and embed EDI awareness and initiatives within organisational culture.

We believe a robust evidence base is essential for identifying all barriers to individuals participating and thriving in cancer research. It is also important to ensure the most effective actions are taken to improve equality, diversity and inclusion in research, whilst acknowledging that further research into exploring the issues and causes is required. That’s why CRUK was one of the UK’s first charity research funders to publish diversity data in our grant funding[xvii], having gathered improved diversity data since 2017. We wanted to be transparent about who was successfully awarded research grants and how this related to the characteristics of applicants, awardees and committee members.

CRUK’s EDI in research action plan[xviii] aims to address issues identified in our diversity data and lays out our commitments as a funder to develop a more diverse and inclusive research community and contribute to tackling systemic issues like underrepresentation and racial bias. Our action plan aims include:

1. Ensuring more diverse researchers are attracted to, retained and working in, cancer research
2. Using our influence to ensure a diverse and inclusive research culture
3. Funding research of the highest quality that is relevant to, and where appropriate involves, a diverse population of research participants

Ongoing dialogue with our research community is essential to understand the different barriers and issues people face and their ideas for how we can do better. Feedback from a webinar with our research community[xix] helped shape actions in our action plan to help tackle racial bias in cancer research.

Ensuring more diverse researchers are attracted to, retained and working in, cancer research
Under our EDI in research action plan, CRUK has prioritised putting new career support initiatives in place to diversify our research careers pipeline. This includes initially focusing on earlier career stages to ensure more young people from underrepresented and diverse backgrounds can enter the academic pipeline, before we systematically move onto other stages of the career pathway.

CRUK partners with expert charitable organisations and grassroots networks set up by researchers to help attract underrepresented researchers to a career in cancer research:

• In2ScienceUK[xx] provide young school children from low-income and disadvantaged backgrounds with practical insights into the STEM sector.
• In2ScienceUK’s In2Research programme[xxi] supports undergraduate students from underrepresented backgrounds to progress to a PhD in cancer research.
• The Black in Cancer Network[xxii] runs a mentorship programme, pairing up black undergraduate students with cancer researchers via mentorships and summer placements.

CRUK has also introduced initiatives to help support and retain researchers from diverse backgrounds in cancer research:

• StellarHE’s Diverse Leaders course[xxiii] is a leadership course for diverse leaders in the higher education sector. To date, CRUK has funded two researchers from ethnic minority backgrounds to participate in their leadership programme.
• CRUK’s Women of Influence mentorship scheme[xxiv] aims to tackle some of the barriers our female Fellows may face when progressing to senior positions. Our scheme pairs exceptional female scientists with leading businesswomen to provide early career researchers with support from outside of academia at a critical time to help them achieve their full potential as research leaders. More than 50 CRUK fellows have benefitted from their mentor’s experience in leadership and management since the scheme was established in 2014.

CRUK promotes flexible research career policies[xxv] enabling researchers to choose to work part-time on our awards and providing support if researchers need to take long-term leave during their award. In 2018, CRUK removed the post-PhD time restrictions for fellowship applicants[xxvi], enabling our scheme to better support those who have taken a diversity of career routes and additionally increasing flexibility for applicants such as those who have taken time out for caring responsibilities or for health reasons.

To ensure fair and inclusive funding processes, where success is determined by scientific quality and nothing else, CRUK has improved the way we assess research so that researchers are fairly valued for the quality of their work, their skills and experiences. CRUK has clear guidance for assessing grant applications[xxvii] for its Committee and Panel members to ensure CRUK’s peer review process recognises a full range of research outputs and is objective, fair and free from bias.

In 2021, CRUK signed a Funders Joint Statement: Exploring a shared approach towards a narrative CV[xxviii] based on the Royal Society’s Résumé for Researchers (R4R). We collectively believe sustained excellence in research and innovation requires a range of contributions and recognition of those activities. Enabling the diverse R&D workforce to demonstrate who they are as individuals, and how they contribute to teams and the wider research and innovation endeavour, beyond grant and publication record, will transform who and what activities are valued. The R4R approach will help us ensure we are attracting and retaining the full range of the most promising research and innovation talent.

Due to the COVID-19 pandemic, CRUK recognised those with caring responsibilities or health conditions may face additional barriers returning to work as normal. To ensure our funding processes were inclusive, CRUK introduced a new section on all grant application forms to ask about the impact of COVID-19 on the applicant and their research[xxix]. Guidance is provided to expert reviewers on how to take this disruption into consideration.

Ensuring diverse membership of funding committees that review grant applications for funders is essential. CRUK has set targets for at least 40% female membership on each of CRUK’s funding committees and for at least 20% of committee members from ethnic minority backgrounds. CRUK has made progress by nearly doubling the number of female researchers on our funding committees in five years to 39% by proactively addressing existing gaps.

Using our influence to ensure a diverse and inclusive research culture

Key to any efforts to improve diversity in STEM is using our influence as a research funder to promote a positive and inclusive research culture. Positive research culture means researchers can develop their ideas in a supportive, collaborative environment; an environment which fosters world-class science and innovation that will help more people survive cancer.

Under CRUK’s framework for positive research culture[xxx], we will help create positive, diverse and inclusive research environments that allow all brilliant minds to collaborate, flourish and progress. In 2018, CRUK issued new policies to tackle bullying and harassment in the research workplace. Following a recent survey[xxxi], bullying and harassment was rated as having the most negative influence on research integrity. CRUK is a member of the collaborative Forum for Tackling Bullying and Harassment in Research and Innovation[xxxii] which aims to support system level change across the research and innovation landscape.

CRUK is also a proud signatory of the Concordat to Support the Career Development of Researchers[xxxiii] (Researcher Development Concordat), an agreement between stakeholders to improve the employment, culture and environment for researchers and researcher careers. In 2021, we published our CRUK action plan under the Concordat[xxxiv].

Funding research of the highest quality that is relevant to, and where appropriate involves, a diverse population of research participants

CRUK has put strategies in place to tackle inequalities in cancer through the research we fund, including by:

• Embedding EDI considerations in CRUK-funded cancer trials;
• Proactively driving a research ecosystem that generates evidence in cancer inequalities.

Embedding EDI considerations in CRUK-funded cancer trials

CRUK aims to ensure trial patients reflect the target population and to identify and reduce barriers to trial participation faced by underserved groups. Anecdotally from our CRUK clinical research community, not all locations collect broad diversity data and trial participants do not represent relevant target populations.

CRUK is aiming to address this underrepresentation in clinical research, engaging with our research community and patients to help understand issues in underrepresentation. We have recently published a new policy for research involving the recruitment of human participants[xxxv] which set our expectations on including underserved populations. We will introduce explicit requirements for grant applicants to set out how they will increase inclusivity in research studies.

CRUK is linking with NIHR INCLUDE[xxxvi] and the INCLUDE Ethnicity Framework[xxxvii], providing webinars to our research community on how trial teams could start to achieve diverse representation, as well as ensuring recommendations of NIHR INCLUDE questions, to facilitate reaching underserved populations, are considered by CRUK supported trial teams.

Proactively driving a research ecosystem that generates evidence in cancer inequalities
CRUK recognises that more cancer inequalities research is needed to understand why some groups of people may be more or less likely to develop cancer, experience cancer-related problems or die from cancer than others[xxxviii]. For example, an increasing number of studies demonstrate that even when socioeconomic and access to care factors are accounted for, incidence and mortality gaps persist between ethnic minority populations for some cancer types, which suggests a role for biological contributors not yet fully understood[xxxix]. Furthermore, there is limited evidence on the relative contribution of different characteristics and socioeconomic factors on disparities and inequalities in cancer outcomes; this evidence base would be enhanced by appropriate data collection and disaggregated analysis as well as more dedicated research into inequalities[xl].

Building on CRUK’s commitment in our EDI in Research Action Plan to address cancer inequalities[xli], CRUK is developing a cancer inequalities strategy to proactively drive a research ecosystem that generates evidence to drive policy change to reduce cancer inequalities. Through engagement and consultation with others, including with patients and our research community, we will review how to holistically integrate and address cancer inequalities across the research continuum through our research funding activities. We will fund ambitious, ground-breaking research across disciplines that digs into biological underpinnings, and will look to harness international collaboration in order to explore and understand the similarities and differences between populations, which will help us understand and work with partners to address these inequalities.  
 

3. What could and should be done by the UK Government, UKRI, other funding bodies, industry and academia to address the issues identified?

Fixing the system will take time and a collaborative effort and we must all take action now. Everyone – researchers, research institutions, research funders, industry, policymakers – need to work together to bring about systemic change.

In 2021, CRUK welcomed the new R&D People & Culture Strategy[xlii], particularly the call to action and acknowledgement of the long-standing issues in the strategy – from bullying and harassment to equality, diversity and inclusion. The strategy sets out a bold ambition to make the UK the best destination in the world for science and research and explains how Government intends to work with organisations across the sector to drive change. However, questions remain around how these actions will be implemented. The strategy also shies away from some of the key issues such as racism, bias, prejudice and other forms of discrimination.

CRUK take our role in addressing these issues very seriously – we know the best way to bring forward the day when all cancers are cured is to support the most inclusive and positive research environments. We will do this by ensuring we are at the forefront of removing barriers to research and tackling inequalities.

Our recommendations:

Due to the systemic nature of the problem, tackling issues at a system-level requires a focus on the entire pipeline, from STEM education in schools, colleges, and undergraduate courses, through to the processes of funding research and the research culture that currently create an unrepresentative research environment.

• The UK Government should develop a comprehensive, sector-wide strategy to increase diversity in the STEM research workforce that:
• Takes a long-term approach and includes interventions at different career stages to build a solid pipeline, and which starts from engaging a diverse range of school children in STEM.
• Makes consistent commitments to EDI across the STEM sector that is not reliant on individual champions or underfunded grassroots organisations.
• Builds a more inclusive and equal STEM research community.
• Links with strategies to address disparities in health research and health outcomes.

• All stakeholders should foster a positive research culture. It is incumbent upon everyone – researchers, research institutions, research funders, industry and policymakers to work together to achieve lasting change. Scientific progress is driven by a diverse range of contributions, but the research system currently favours success metrics that reinforce individual prestige and publication history and that undervalue other important skills and activities. A sector-wide conversation about research culture has brought many of these issues to light and highlighted priorities for action.
• The Government should develop a clear action plan following on from the R&D People & Culture Strategy to move from ambition to implementing changes. This includes developing a research system that recognises, values and rewards everyone in research and their diverse roles and contributions.
• Investing in positive culture and incentives that reflect the true range of contributions is vital. In the short term, Government should drive adoption of the ‘Resume for Researchers’ narrative CV – as set out in the R&D People & Culture Strategy – which broadens the range of experiences and accomplishments that are recognised.

• Funding bodies such as UKRI and Research England should develop or expand positive action schemes to address underrepresentation in research.
• For example, in 2021, Research England and the Office for Students announced 13 new projects to improve Black, Asian and ethnic minority students’ access to postgraduate research. Given the breadth of applications received, consideration should be given to funding further such projects to increase the spread across the country.

• All stakeholders should take proactive steps to remove bias. Left unchecked, bias leads to nurturing, funding, hiring and supporting those who already ‘fit the mould’ and leaves others behind. This includes individual bias, institutional bias, structural bias, and system-level bias.

• Better demographic data and evidence of effective EDI interventions is needed.
• Demographic data collection should be coordinated and harmonised across the STEM sector and any data analysis should be disaggregated and include intersectional data where possible.
• Improve national data collection processes and address data collection gaps in applicant demographics for funded PGR study – from application stage through to place confirmation.
• A lack of consistency in approaches to EDI and evidence of what is effective means that it is hard to assess impact and progress on interventions, to compare methods and outcomes between organisations, and to make clear recommendations about emerging good practice.
• Best practice examples of effective interventions should be shared in a Good Practice Exchange across the sector.

• All stakeholders should ensure COVID-19 does not further exacerbate diversity in STEM issues. Funders and research institutions should take into consideration any disruption to research activities or outputs when assessing an individual’s record of outputs, research achievements, and career progression.

About Cancer Research UK

Cancer Research UK (CRUK) is the world’s largest cancer charity dedicated to saving lives through research. We support research into over 200 types of cancer, and our vision is to bring forward the day when all cancers are cured. Our long-term investment in state-of-the-art facilities has helped to create a thriving network of research at 90 laboratories and institutions in more than 40 towns and cities across the UK, supporting the work of over 4,000 scientists, doctors and nurses. In 2020/21, Cancer Research UK invested £421 million on new and ongoing research projects into the causes and treatments for cancer.

References