520 Background: Telehealth availability and use expanded rapidly at the start of the COVID-19 pandemic and continues to be a care delivery option for both cancer patients and their providers. Methods: Using data from the 2022 Health Information National Trends Survey (HINTS 6), we characterized telehealth use among U.S. adults with a history of cancer (n=842). Survey-weighted proportions were calculated to describe reasons for telehealth use, non-use, and patient experiences with telehealth. Survey-weighted bivariate logistic regressions were used to further identify sociodemographic and health-related factors associated with telehealth use. Results: Among the 842 cancer survivors, 50% reported no telehealth use in the last 12 months and 50% reported a telehealth encounter. Among survivors that reported no telehealth use, 77% indicated they were not offered telehealth. Among non-users given a telehealth option, most (91%) chose not to participate because they preferred an in-person visit, though some reported concerns about the difficulty of using telehealth technology (28%) or the privacy of telehealth visits (13%). Among survivors reporting telehealth use, 44% used video, 30% phone, and 26% phone and video. The most common reason for choosing telehealth was a provider recommendation (79%), followed by convenience (59%), avoiding possible infection (40%), and inclusion of caregivers (26%). Most survivors who used telehealth reported that the care they received was as good as an in-person visit (77%), though some reported technical difficulties (25%) and privacy concerns (11%). Odds of reporting telehealth use were significantly lower among cancer survivors aged 65+ (vs. <65, OR=0.55, 95% CI 0.34-0.88) and higher among gay and bisexual adults (vs. heterosexual; OR=1.29, 95% CI 1.10-7.09) and those reporting worse health (fair/poor vs. excellent, OR=3.49, 95% CI 1.63-7.49). Telehealth use was not associated with sex, race/ethnicity, education, geographic residence, medical comorbidity, time since diagnosis, or use of high-speed internet. Conclusions: Lack of provider recommendation to use telehealth may be a barrier to greater adoption among cancer survivors. Conversely, provider recommendation was associated with higher telehealth uptake, highlighting the need for provider engagement and support of telehealth options. Lower odds of telehealth use among older survivors supports prior digital divide research, though other commonly reported disparities were not significant. In contrast, gay and bisexual survivors as well as survivors with self-perceived poor health reported the highest rates of telehealth use, demonstrating a unique opportunity for telehealth use to meet care needs among these cancer survivor populations.