Sociodemographic Disparities and Reasons for Delayed Healthcare Among U.S. Cancer Survivors: An All of Us Study.

Objective: To examine how sociodemographic factors influence healthcare access among cancer survivors. Methods: From the National Institutes of Health's All of Us dataset (2018-2022, n = 27,589), we analyzed the relationship between characteristics like age, income, race/ethnicity, and insurance, and reasons for delayed healthcare, including affordability, transportation, and nervousness. Results: The top reasons for delayed care were affordability issues (12%), nervousness (8%), and transportation barriers (6%). Younger survivors (ages 18-39), those on Medicaid, and individuals earning less than $25,000 annually consistently experienced higher rates of delayed care. Female survivors were more likely to delay care for all reasons except transportation. Work and caregiving-related delays were more common among minoritized racial/ethnic groups, while non-Hispanic White survivors more often delayed care due to nervousness and socioeconomic factors. Conclusions: Considerable differences in delayed healthcare were observed among cancer survivors by sociodemographic characteristics, with evidence for intersectionality for several observed associations. Findings highlight the need for personalized patient navigation strategies to effectively address the unique social needs of each cancer survivor, ultimately improving healthcare access for all.