Patterns and Determinants of Telehealth Use by Cancer Survivorship: A National Online Survey.

INTRODUCTION Since the COVID-19 pandemic, telehealth utilization has increased substantially and remained well above pre-2020 levels. This study sought to determine whether cancer survivorship phase predicts telehealth utilization, perceived barriers, and benefits, informing future strategies to enhance digital care for this immuno-compromised population.

Methods

We conducted a national cross-sectional survey to examine telehealth utilization among adults with and without a history of cancer (n = 202). Participants were categorized as no cancer (n = 40), having cancer 1-5 years since diagnosis (n = 79), and having cancer ≥6 years since diagnosis (n = 83). The primary outcome was utilization pattern by cancer history, and the secondary outcomes were determinants (5 perceived benefits and 6 perceived challenges) of telehealth use. Multivariable regression analyses of quantitative data and thematic qualitative analyses of qualitative responses were performed.

Results

Adults diagnosed with cancer in 5 years demonstrated higher telehealth utilization followed by those with cancer for 6+ years, while those who never had cancer were least likely to engage (80.3%>62.5%>40.0%, p < 0.001). The most common challenge was poor internet quality (47.4% of the recent-cancer group) although there is no significant difference found. All three groups reported that flexibility was the most important benefit (p = 0.034). Qualitative analysis echoed these findings, highlighting flexibility as major benefits (61.5%).

Conclusion

Qualitative responses complemented the quantitative data with a better understanding of eight determinants of telehealth use. Policies promoting broadband reliability, multilingual access, and digital literacy are key to equitable telehealth engagement that meets different needs across cancer histories.