Abstract 1380: 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 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.