Adherence to American Society of Clinical Oncology (ASCO) language of respect (LoR) guidelines in ASCO Annual Meeting prostate cancer (PCa) abstracts.
Authors: Barragan-Carrillo Regina , Wong Megan Hoikei , Dizman Nazli , Castro Daniela V. , Mercier Benjamin D. , Li Xiaochen , Faridi Amber , Goud Jaya , Paul Trishita , Chan Ethan , Dukkipati Akasha , Paul Teebro , Zugman Miguel , Ebrahimi Hedyeh , Dorff Tanya B. , Chehrazi-Raffle Alex , Pal Sumanta Kumar , Florez Narjust , Prowell Tatiana Michelle 
Published: January 2024

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Background: The ASCO LoR guidelines were adopted by ASCO in advance of the 2020 Annual Meeting to promote use of patient-respectful language in Annual Meeting presentations. The guidelines call on the oncology community to avoid language that dehumanizes people living with cancer or casts blame. We sought to evaluate adherence to these guidelines in PCa abstracts accepted to the 2023 ASCO Annual Meeting. Methods: Six reviewers screened all PCa abstracts presented at the 2023 ASCO Annual Meeting and tabulated all statements that referred to patients related to diagnosis, treatment, or clinical outcome. Sentences were classified according to their compliance with the 3 principal LoR directives: (1) “Do not blame patients,” (2) “Respect the role of the patient,” and (3) “Do not dehumanize patients.” All abstracts were evaluated by two independent reviewers. Each abstract was given a conformity score based on the extent to which the overall abstract adhered to the LoR guidelines. Descriptive statistics were used to characterize compliance across abstracts. Univariate and multivariate analyses were used to identify factors associated with non-compliance with guidelines. Results: We reviewed 195 PCa abstracts. Most abstracts were accepted as poster presentation (52%) followed by publication only (45%) and oral abstract (3%). The majority were clinical (81%) or translational (17%) research. 85% of the abstracts had a first author affiliated with a native-English speaking institution. Most abstracts came from multi-institutional collaborations (84%), and from a single country (67%). In total, 119 (61%) of abstracts contained at least one non-compliant statement. Among the directives not followed, “Do not dehumanize patients” had the lowest compliance score in 49% of statements, followed by “Do not blame the patient” in 17%, and “Respect the role of the patient” in 1%. We explored potential associations between primary author’s institution, country and number of collaborating institutions. Univariate analysis demonstrated greater odds of non-adherence to LoR guidelines in abstracts whose first author was affiliated with an institution in a non-English speaking country (OR 2.80 [95% CI 1.08-7.23, p=.034]. Multivariate analysis was not significant. Conclusions: Despite formal guidelines having been adopted by ASCO in 2020, the majority of PCa abstracts selected for the 2023 ASCO Annual Meeting contained at least one statement that did not adhere to the LoR guidelines. The only factor that identified an increased OR of non-adherent language was submissions from a non-English speaking institution. Translation of the LoR Guidelines into other languages, international educational outreach, and increased attention to language in the abstract review process are recommended.