Patient-reported care experiences from the Medical Expenditure Panel Survey (MEPS) among immigrant cancer survivors.

405 Background: Cancer survivors often experience complex, multifaceted challenges while navigating cancer care, including many interactions across health systems and care teams. For immigrants, cultural and language barriers may further complicate their cancer care experience. In this study, we sought to compare care experiences based upon immigrant status and speaking another language at home for cancer survivors. Methods: We used the MEPS database from 2019-2022 and extracted data about survivor factors (age, sex, race, marital status, immigrant status, speaking another non-English language at home) and cancer type for all adults > 18 years with self-reported history of cancer. We compared care experiences (i.e., if provider asks about treatments/medications from other providers, if provider explains all treatment options, includes patient in medical decision-making, usual place for medical care, and delays in medical care) by immigrant status and speaking another language at home using Rao-Scott Chi-square test accounting for the complex survey design of the MEPS. Results: We identified 7,771 cancer survivors (63.4% age 65+, 59.4% female, 82.5% White, 50.6% married). Most common cancers were breast (21.6%) and prostate (15.3%). Overall, 10.3% were immigrants and 11.4% reported speaking another language at home. Immigrant cancer survivors and those speaking another language at home were more commonly younger, female, Hispanic, Asian, married, less educated, living below the poverty line, and had non-private insurance (p < .05 for all). Immigrant survivors were less likely to report a provider asked about other treatments (58.5% v 64.6%, p = .022), explained all treatment options (71.6% v 78.2%, p = .032), and included patient in making medical decisions (38.8% v 45.7%, p = .007). Immigrants were more likely to report outpatient clinics as usual place for care (25.0% v 21.6%, p < .001) and were less likely to report delays in medical care due to cost (6.1% v 6.9%, p = .022) than survivors born in the U.S. Cancer survivors who reported speaking another language at home were less likely to report a provide asked about other treatments (58.6% v 64.6%, p = .015), explained all treatment options (71.7% v 78.2%, p = .017), and included patient in making medical decisions (36.5% v 46.0%, p < .001). They were also more likely to report outpatient clinics as usual place for care (25.7% v 21.5%, p < .001). We found no differences in reporting delays in medical care due to cost (6.6% v 6.9%, p = .059). Conclusions: In this national survey study, we found differences in patient-reported care experiences (i.e., discussions about treatments, shared decision-making, care access) for immigrant cancer survivors and those speaking another language at home. Future work should focus on enhancing the cancer care experience in culturally and language appropriate ways for all.