Are age and sex associated with variation in use of follow-up care and financial barriers to care in U.S. cancer survivors?

Purpose Long-term follow-up of cancer survivors is essential. How prevalent are lack of adequate follow-up and financial barriers to care among U.S. cancer survivors, and how does this vary by patients’ demographic characteristics? Methods We analyzed data from the 2019–2024 National Health Interview Survey. Among adults age 18+ , we identified 23,142 reporting ever receiving a cancer diagnosis. We assessed indicators of inadequate follow-up care and financial barriers to care. We performed multivariable logistic regression to assess demographic characteristics associated with inadequate follow-up and financial barriers. Results Overall, 10.4% of survivors had inadequate follow-up, and 10.9% reported financial barriers to care. Higher rates were observed among younger (age 18–44) survivors, 22.9% of whom had inadequate follow-up ( p < 0.001), and 21.0% of whom reported a financial barrier ( p < 0.0001). While younger men (vs. women) 18–44 had higher odds of inadequate follow-up (aOR 1.82, 95% CI 1.32–2.51), male survivors overall had lower adjusted odds of financial barriers (aOR 0.70, 95% I 0.69–0.79). Conclusions Over one in ten U.S. adult cancer survivors – and more than one in five younger adults with a cancer history lack adequate follow-up care and face financial barriers to care. Although younger men were particularly likely to have inadequate follow-up, men faced fewer financial barriers. Implications for Cancer Survivors Millions of U.S. cancer survivors receive inadequate follow-up and face financial barriers to care. Ongoing efforts to keep survivors engaged in care, and research to further elucidate barriers to care, are essential for providing high-quality care to cancer survivors.