Patient administrative burden in cancer care: Results of a national survey.

65 Background: Across the cancer care continuum, the science of cancer prevention, treatment, and surveillance is complex and rapidly evolving. In addition to the financial toxicity of cancer care, there is a growing appreciation for the time and effort patients must invest in navigating the health care delivery system. Patients’ nonfinancial costs, including administrative burdens, are recognized access barriers, but are understudied relative to financial costs. Methods: We previously developed and validated a survey instrument measuring patient administrative burden in cancer care delivery, focused on adults with a new, recurrent, or metastatic cancer diagnosis within the past 12 months for which they are receiving systemic therapy. We administered the survey in April 2025 via the Ipsos KnowledgePanel, a probability-based, nationally representative sample of U.S. households (completion rate = 85%). Responses were weighted to reflect the U.S. population of adults with cancer. Results: In a nationally representative sample of patients diagnosed with a new, recurrent, or metastatic cancer in the past 12 months and treated with systemic therapy (n = 409), we found that 75.5% of reported delayed or foregone care due to administrative burdens. We further classified administrative burdens related to insurance interactions, provider organization interactions, and care coordination between multiple parties. Among insurance tasks (e.g., finding a doctor in network, dealing with billing issues, prior authorizations, coverage denials), 51.5% of respondents reported a difficulty, 19.6% of those reporting a difficulty experienced delayed/foregone care as a consequence, and 81% of those reporting delayed/foregone care reported a negative impact on their health. Among provider-facing tasks (e.g., scheduling appointments, reaching oncology practices by phone, using patient portals), 57.8% of respondents reported difficulty with at least one task, 20.5% of those reporting a difficulty experienced delayed or foregone care, and 65.5% of those experiencing delayed/foregone care reported a negative impact on their health. Finally, among care coordination tasks (reconciling conflicting information, pharmacy did not have medication available when needed, sent for duplicate testing), 36.5% reported experiencing a care coordination challenge, of which 43.9% reported experiencing a delay, and 64.3% of those experiencing a delay reported negative health consequences. Conclusions: Patient undergoing systemic treatment for cancer frequently experience administrative burdens, with consequences for timely access to care and health outcomes.