Adherence to ASCO Language of Respect (LoR) guidelines in urothelial carcinoma (UC) abstracts at the 2023 ASCO Annual Meeting.
Authors: Castro Daniela V. , Mercier Benjamin D. , Zugman Miguel , Li Xiaochen , Barragan-Carrillo Regina , Wong Megan Hoikei , Chan Ethan , Faridi Amber , Goud Jaya , Paul Trishita , Dukkipati Akasha , Patel Jalen , Paul Teebro , Ebrahimi Hedyeh , Chawla Neal Shiv , Chehrazi-Raffle Alex , Prowell Tatiana Michelle , Florez Narjust , Dizman Nazli , Pal Sumanta Kumar 
Published: January 2024

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Background: The Language of Respect (LoR) guidelines of ASCO were developed to promote patient-centered language and demonstrate the highest levels of respect and empathy when referring to people with cancer. In this study, we aimed to characterize the proportion of urothelial carcinoma (UC) abstracts from 2023 ASCO Annual Meeting that complied with these guidelines. Methods: AllpublishedUC abstracts from 2023 ASCO Annual Meeting were reviewed and validated for statements that complied with or deviated from the LoR guidelines by 6 reviewers. Collected statements were stratified into 3 groups in accordance with guideline recommendations: (1) Do not blame patients, (2) Respect the role of patients, (3) Do not dehumanize patients. Descriptive statistics were used to characterize compliance. Univariate and multivariate analyses were used to identify factors associated with non-compliance with the guidelines before and after adjustment for potential confounders such as presentation type, first author affiliation, and country of origin. Results: Overall, 120 abstracts were reviewed, of which 3 were excluded as they were basic science studies or lacked patient enrollment and did not include evaluable verbiage. 47.9%, 47.0%, and 5.1% of abstracts were accepted as online publication only, poster, and oral presentation, respectively. First authors were affiliated with institutions in native English-speaking countries (NESC) in 83 (70.9%) abstracts and non-native English-speaking countries (NNESC) in 34 (29.1%) abstracts. 75.2% of abstracts included authors from multiple institutions, and 70.1% included authors from a single country. 68.4% of abstracts contained at least one noncompliant statement, while 53.0%, 33.3%, and 0.9% had at least one statement that violated the “Do not dehumanize patients”, “Do not blame”, and “Respect the role of patients” guidelines, respectively. In univariate analysis, abstracts with authors from a single country and abstracts with first authors from NNESCs had greater odds of containing at least one statement noncompliant with the LoR guidelines (OR 2.93, 95%CI 1.27-6.73 [p=0.011] and OR 3.64, 95%CI 1.28-10.37 [p=0.016], respectively). Multivariate analysis showed that none of the assessed author characteristics were significantly predictive of noncompliant language. Conclusions: In this observational study, we found that a substantial proportion of UC abstracts failed to adhere to ASCO’s LoR guidelines. Multilingual translations of the LoR guidelines, broader educational outreach, and attention to LoR adherence in the abstract review process may increase use of patient-respectful language at the ASCO Annual Meeting.