Understanding communication and healthcare utilization patterns among survivors of adolescent and young adult cancer: Results from the Health Information National Trends Survey.

520 Background: Adolescents and young adults (AYAs) with cancer face challenges transitioning from active cancer treatment to survivorship. Communication barriers with healthcare providers may contribute to these challenges and lead to fragmented care, but to date, this has not been studied in a national context. To address this gap, we evaluated patient-centered communication (PCC) and healthcare utilization patterns among survivors of AYA cancer. Methods: We analyzed Health Information National Trends Survey data from 6 cycles (2017–2024). Eligible respondents were diagnosed with cancer between ages 15–39. Our outcomes included number of healthcare visits in the prior 12 months, the validated PCC scale (range 0-100, 100=excellent), treatment experiences, and satisfaction with care. Predictor variables included socio-demographic and clinical characteristics. Associations were determined using two-sided Chi-squared and t-tests. Statistical significance was set at p<0.05. Results: Among 708 survivors of AYA cancer (mean age at cancer diagnosis: 30 years; mean age at survey: 58 years) who met eligibility criteria, 74% were female; 66% Non-Hispanic White (NHW), 11% Non-Hispanic Black (NHB), 10% Hispanic/Latinx (H/L). Most (76%) completed college, 95% had insurance, and 29% had a household income <$35,000. A higher percentage of AYAs <40 years had >10 healthcare visits (25%) compared to those 41–60 years (14%) and >60 years (12%), p<0.01. A higher percentage of NHB (19%) had >10 healthcare visits compared to NHW (13%) and H/L (15%). Overall, H/L reported lower mean PCC scores (mean=68, SD=24) compared to NHW (mean=75, SD=22) and NHB (mean=81, SD=23). NHW respondents (62%) were more likely to communicate electronically with providers than NHB (41%) and H/L (57%), p<0.01. Care satisfaction was lowest among AYAs identifying as other race/ethnicity (75%) vs. NHW (87%); NHB (84%); H/L (81%), p=0.01. Discrimination and unfair treatment were higher among NHB (37%) and H/L (28%) survivors compared to NHW (3%), p<0.01. Conclusions: Younger survivors report significantly higher healthcare utilization compared to older survivors, while NHB and H/L survivors experience more discrimination compared to NHW survivors. H/L survivors report worse PCC compared to others. Our findings highlight national inequities in communication, healthcare utilization, and treatment experiences among survivors of AYA cancer, revealing opportunities for targeted interventions.