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Association of literature metrics in gynecologic oncology with country classification by income level
  1. Gabriel Levin1,2,
  2. Rene Pareja3,
  3. Ross Harrison4,
  4. Pedro T Ramirez5 and
  5. Raanan Meyer6,7
  1. 1 Department of Gynecologic Oncology, Hebrew University of Jerusalem, Jerusalem, Israel
  2. 2 Lady Davis Institute for Medical Research, Montreal, Quebec, Canada
  3. 3 Gynecology, Gynecologic Oncology, Clinica ASTORGA, Medellin, and Instituto Nacional de Cancerología, Medellin, Colombia
  4. 4 Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, USA
  5. 5 Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, Texas, USA
  6. 6 Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Cedars Sinai Medical Center, Los Angeles, CA, USA
  7. 7 The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
  1. Correspondence to Gabriel Levin, Department of Gynecologic Oncology, Hebrew University of Jerusalem, Jerusalem, 91904, Israel; Gabriel.levin2{at}


Objective Bibliometric literature in gynecologic oncology is limited. We aimed to study the association between the level of income of the country of authorship and citation metrics.

Methods A retrospective study including all articles and reviews published during 1977–2022 in the International Journal of Gynecological Cancer (IJGC) and Gynecologic Oncology journals. Country of origin was defined as the corresponding author’s address. We classified articles into groups by level of income of the country of origin, as defined by the World Bank. The primary outcome measure was the median number of citations per year.

Results A total of 9835 articles were included in the analysis (IJGC n=3786 (38.5%), Gynecologic Oncology n=6049 (61.5%)). There were 8587 (87.3%) publications from high income countries, 1134 (11.5%) from upper-middle income countries, and 114 (1.2%) from lower-middle income countries. There were no publications from countries of low income. Most publications originated in the United States with 4089 (41.6%), followed by China (n=730, 7.4%), Italy (n=533, 5.4%), Canada (n=467, 4.7%), and Japan (n=461, 4.7%). Over the most recent 5 years there was a decrease in the representation of upper-middle income countries and lower-middle income countries; 16.3% (91/557) in 2018 versus 9.1% (38/417) in 2022 (p=0.005). In a multivariable regression analysis that included year of publication, open access publication model, study being supported by funding, publishing journal, review article, and level of income, all factors were associated with high citation per year score except the income classification of the article’s country of origin (adjusted OR 1.59–1.72, 95% CI 0.61 to 4.30).

Conclusion High income countries have a disproportionate representation in gynecologic oncology publications. After adjusting for confounders, the country’s level of income was not independently associated with a high citation per year score. This implies that the number of citations per year is not compromised by the country’s level of income.

  • Gynecology

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Contributors GL: conceptualization, data curation, methodology, investigation, formal analysis, writing—original draft, writing—review, and editing. conceptualization, project administration, guarantor. RM: data curation, methodology, investigation, writing—original draft, writing—review. RP: writing—review and editing RH: writing—review and editing. PR: writing—review, editing, supervision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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