Abstract C101: Impact of social risks on acute and preventive care in AYA cancer survivors

Abstract Background: Adolescent and young adult (AYA) cancer patients often experience social risks—such as food insecurity, housing instability, and transportation barriers—that may impede access to healthcare. This study examined the prevalence of social risks within a large integrated healthcare system and their association with healthcare patterns among AYA cancer survivors. Methods: We conducted a cross-sectional study of 1,239 AYA cancer survivors (ages 15–39) within Kaiser Permanente Northwest who completed a social risk screening between 2022 and 2024. Patients were categorized by the presence of any social risk (≥ 1 vs. 0). Healthcare use following screening included primary care, obstetrics/gynecology (ob/gyn), urgent care, emergency department (ED), and inpatient admissions. Multivariable logistic regression was used to estimate the association between social risk status and each healthcare use category, adjusting for prior healthcare use, age at diagnosis, sex, insurance type, time since diagnosis, cancer type, and elixhauser comorbidity score. Results: Thirty percent (N=372) of AYA survivors reported ≥ 1 social risk: financial hardship (77%), food insecurity (59%), housing instability (38%), and transportation difficulties (21%). Those with social risks were more likely to have non-commercial insurance (33% vs. 10%, p < 0.0001), have received medical financial assistance before screening (22% vs. 12%, p < 0.001), and have a comorbidity score ≥3 (14% vs. 7%, p = 0.0002). They also resided in more socioeconomically disadvantaged areas (mean index: −0.01 vs. −0.20, p < 0.0001) with lower median household income ($74,251 vs. $80,360, p < 0.0001) compared to those with no social risks. Despite lower in-network out-of-pocket costs ($1,926 vs. $2,441, p = 0.003), AYA survivors with social risks had significantly higher ED use (30% vs. 23%, p = 0.012), but lower use of ob/gyn care (45% vs. 56%, p = 0.009) and inpatient admissions (14% vs. 22%, p = 0.001). In adjusted models, social risk was associated with lower odds of ob/gyn visits among females (OR: 0.67; 95% CI: 0.48–0.94) and inpatient admissions (OR: 0.46; 95% CI: 0.31–0.70). No significant differences were found for primary care, urgent care, or ED visits. Conclusions: One in three AYA cancer survivors reported at least one social risk, highlighting a substantial burden of non-medical challenges during survivorship. Social risk was associated with lower utilization of inpatient and gender-specific preventive care, suggesting that unmet social needs may disrupt engagement with critical health services. Integrating social care into survivorship planning may support more equitable access to and outcomes in healthcare for adolescent and young adult (AYA) populations. Citation Format: Carol Y. Ochoa-Dominguez, Erin Keast, Kimberly A. Miller, David M. Mosen, John F. Dickerson, Randall Y. Chan, Matthew P. Banegas. Impact of social risks on acute and preventive care in AYA cancer survivors [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C101.