e23160 Background: International oncology conferences shape scientific careers, guideline adoption, and global research networks. We systematically quantified how affordability of attending the ASCO Annual Meeting (AM) varies across world regions/income groups using income-equivalent metrics. Methods: We conducted a longitudinal, multi-component cost analysis of ASCO AM from 2021–2025 for physicians across all World Bank regions and income strata. Total direct costs included travel, accommodation, registration, visa fees, and foregone clinical income from five missed working days. Travel costs were modeled using representative regional hub cities; U. S. airfare data were obtained from U. S. Department of Transportation reports, while international airfare trends were adjusted using the U. S. CPI Airline Fares Index (2025 baseline). Accommodation and daily expenses were estimated using Choose Chicago hotel performance data and U. S. GSA per diem rates. Registration fees were obtained from publicly available sources, with missing values estimated by linear interpolation. Affordability was assessed using two complementary metrics: the Cost-to-Income Ratio (CIR), expressed as income-equivalent time in months, and a GNI-based Affordability Ratio (ARGNI). Physician incomes were estimated using World Bank GNI per capita adjusted with WHO Global Health Workforce Statistics–based wage multipliers. Results: ASCO attendance required > 10-fold more income-equivalent time for LMIC than HIC physicians. Mean CIR was 0. 44 for HIC physicians (≈0. 4 m of income) versus 4. 35 for LMIC physicians, exceeding four months of income. When expressed as income-equivalent time by region, total attendance costs corresponded to 0. 2 months of physician income in North America, compared with 11 months in South Asia and over 25 months in Sub-Saharan Africa. Regional and income-stratified CIR and ARGNI values are summarized in Table 1. Registration fees accounted for less than 15% of total costs across most regions, indicating that income-adjusted registration alone does not address affordability barriers. Conclusions: International oncology meetings are essential for professional development and knowledge exchange, and current ASCO affordability measures contribute meaningfully to access. However, overall attendance costs differ substantially across regions and income groups, reflecting the influence of travel-related and opportunity costs beyond registration fees. This analysis provides data to inform continued initiatives to enhance equitable global participation. ARGNI and CIR by world regions and incomes. Region/Income Level ARGNI CIR expressed as Income-equivalent time (month) North America 1. 09 0. 2 Europe/Central Asia 1. 98 0. 5 East Asia/Pacific 4. 45 1. 4 Latin America/Caribbean 5. 08 1. 5 Middle East/North Africa 7. 96 2. 7 South Asia 16. 81 11. 2 Sub-Saharan Africa 33. 30 25. 3 HIC 1. 99 0. 44 LMIC 8. 3 4. 3
Hovsepyan et al. (Thu,) studied this question.