Key result
Telehealth shows ~22% lower initial uptake among Black versus White patients, but disparities later attenuate.
Why the study?
Disparities in telehealth access among cancer patients remain poorly understood, and claim-level utilization patterns may reveal mechanisms different from patient-level adoption.
Are there disparities in telehealth uptake and intensity among older adults with cancer based on race/ethnicity and age?
Cohort (n=573,328)
Yes
Are there disparities in telehealth uptake and intensity among older adults with cancer based on race/ethnicity and age?
Racial/ethnic minorities and older adults face initial barriers to telehealth uptake in cancer care, but those who access it demonstrate higher intensity of use.
Barriers to telehealth uptake in minority older cancer patients warrant targeted outreach; extends disparity research by distinguishing initiation from intensity.
Background: Telehealth use expanded rapidly during the COVID-19 pandemic including for cancer care, however, disparities in telehealth access among cancer patients remain poorly understood. While prior studies examined patient-level telehealth adoption, claim-level utilization patterns may reveal different mechanisms. Methods: We conducted a population-based cohort study using Medicare claims data of patients aged 65+ years diagnosed with bladder, breast, colorectal, gastric, lung, or prostate cancer (2020-2022) with continuous Part A/B enrollment. We examined telehealth utilization within one year of cancer diagnosis using multivariable logistic regression to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) at two levels: (1) patient-level analysis of any telehealth use,and (2) claim-level analysis restricted to cancer-related care identified by cancer-related provider specialties to assess telehealth delivery patterns. Results: Among 573,328 patients generating 5,276,398 cancer-related claims, 60.6% used telehealth within one year of diagnosis, representing 14.6% of cancer care encounters. At the patient level, compared to non-Hispanic White patients, Asian/Pacific Islander (aOR 0.85, 95%CI 0.82-0.88), Black (aOR 0.78, 95%CI 0.77-0.80), and Hispanic (aOR 0.89, 95%CI 0.86-0.91) patients had lower odds of any telehealth use. Compared to ages 65-69, older adults showed steep age gradients, with 85+ having 52% lower odds (aOR 0.48, 95%CI 0.47-0.484). Rural patients had higher uptake versus urban (aOR 1.17, 95%CI 1.16-1.19). At the claim- level for cancer care delivery, disparities substantially attenuated or reversed: Asian/Pacific Islander (aOR 1.15, 95%CI 1.13-1.17), Hispanic (aOR 1.07, 95%CI 1.06-1.09), Black (aOR 0.96, 95%CI 0.95-0.97), and 85+ years (aOR 0.92, 95%CI 0.92-0.94) . Compared to physicians, advanced practice providers had higher delivery (aOR 1.28); female providers versus male (aOR 1.12) and academic versus non-academic centers (aOR 1.08) showed higher use. Conclusions: Telehealth disparities in cancer care may be primarily driven by initial access barriers rather than engagement once accessed. Racial/ethnic minorities and older adults who overcome uptake barriers demonstrate high-intensity telehealth use for cancer treatment, suggesting substantial unmet need. Interventions should prioritize addressing initial access barriers such as digital literacy, technology access, and language services-to ensure equitable cancer care delivery. Citation Format: Sakshith Reddy Chintala, Margaret Meagher, Ceser Delgado, Amir Salmasi, Micheal Liss, Brett Meyer, Richard Cripps, Elena Martinez, Hala Madanat, James Murphy, Juan Javier-DesLoges, Humberto Parada. Patient-level and claim-level analysis of telehealth disparities in cancer care: Lower uptake but higher intensity among racial or ethnic minority groups and older adults [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 1380.
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Chintala et al. (2026) conducted a cohort in Cancer (bladder, breast, colorectal, gastric, lung, or prostate) (n=573,328). Telehealth vs. Non-Hispanic White patients and younger adults (65-69 years) was evaluated on Any telehealth use within one year of cancer diagnosis (aOR 0.78, 95% CI 0.77-0.80). Telehealth use showed lower initial uptake among Black versus White patients (aOR 0.78; 95% CI 0.77-0.80), but disparities attenuated or reversed in claim-level cancer care delivery.
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