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.