The Leaky Pipeline Across Borders: A Cross-sectional Analysis of Gender Parity in Radiation Oncology in Austria and Switzerland.

AIMS: Gender disparities in radiation oncology (RO) persist across career stages, with women underrepresented in leadership and academic positions despite constituting a growing share of the clinical workforce. This study provides the first systematic cross-sectional analysis of gender distribution in RO in Austria and Switzerland, with descriptive data from South Tyrol. MATERIALS AND METHODS: For Austria (n = 231), an institutional census was conducted with approval by the Austrian Society of Radiation Oncology (ÖGRO). For Switzerland (n = 309), data were compiled through internet research and the Swiss medical register. South Tyrolean data (n = 11) are presented descriptively only. Gender, professional role, and academic qualification were recorded. RESULTS: In Austria, women constituted 59.3% of the workforce (P = .005), with a female majority among specialists (63.8%, P = .003), falling to 42.9% at leading positions and 16.7% among full professors (P = .021). In Switzerland, women constituted 42.7% overall (P = .010), declining from residents (45.5%) to leading positions (31.4%, P = .028) and full professors (20.0%, P = .001). Analysis confirmed a significant decline across career stages in Austria (P = .003) and Switzerland (P = .007). In South Tyrol, 81.8% were women, with all specialist positions held by women and both leadership positions held by men. CONCLUSION: Despite differences in overall workforce composition, a consistent leaky pipeline was identified across all three regions, with the most pronounced disparities at leadership and academic levels. These findings support the system-independent nature of gender inequity in RO, establishing a baseline for tracking progress toward parity across the German-speaking region.