Differences in Healthcare and Everyday Discrimination among Racial and Ethnic Minority Cancer Survivors in the all of the US Research Program.

BACKGROUND: Discrimination experiences are associated with negative health outcomes. However, limited studies have examined the discrimination experienced by cancer survivors from racial and ethnic minorities. Our study seeks to analyze these groups' experiences, focusing on the types and patterns of discrimination. METHODS: This cross-sectional study used survey and electronic health record data from the Controlled Tier v7 in the All of Us Research Program. Participants were adults aged 18 or older who self-identified as Asian American, Hispanic American, or Black/African American; had a history of cancer; and responded to discrimination surveys. Validated discrimination scales measured scores in (1) everyday life and (2) healthcare settings. Analysis of variance examined group differences in mean discrimination scores. Chi-square tests assessed group differences in high-level exposure and overlap between settings. RESULTS: 2,546 cancer survivors participated. About 60-70% of survivors experienced everyday discrimination, and over half reported healthcare discrimination. Roughly 30% experienced high-level exposure to discrimination, and 1 in 6 encountered discrimination in both daily life and healthcare. Black/African Americans had significantly higher scores for everyday and healthcare discrimination and a significantly higher rate of high-level exposure than other groups. Meanwhile, Asian Americans experienced a higher everyday overt discrimination score compared to other groups (all p < .05). CONCLUSIONS: Discrimination against racial and ethnic minority survivors is prevalent in daily life and healthcare settings, and its pattern varies across groups. Anti-discrimination policies should focus on survivors' care experiences and deploying healthcare navigators to support racial and ethnic minority survivors who report high levels of discrimination and overlap.