200 Background: Despite Advance Care Planning (ACP) recommendations for patients with cancer for over 20 years, uptake remains low, and many such patients lack Advance Directives (AD). Our previous data showed a lack of association between patient-perceived cancer incurability and AD completion, however less is known about whether this relationship remains for key subgroups where perceptions may differ, such as BIPOC (Black, Indigenous, or People of Color) patients and patients with incurable hematologic malignancies. Methods: This cross-sectional study used Patient Reported Outcomes (PRO) from surveys administered during routine outpatient care at the University of Alabama at Birmingham from 12/2016 to 08/2021. Patients self-reported AD completion and perception of curability. Demographics consisting of age, sex, race and ethnicity, and marital status, and clinical characteristics, namely cancer type, cancer stage (stage 0-III grouped as early vs. IV/progression/recurrence as late) and phase of care (initial being the first 12 months, survivorship starting after this, and end of life being the last 6 months of life) were abstracted from the electronic medical record. Descriptive statistics were calculated using frequencies and percentages for categorical variables and median and interquartile ranges (IQR) for continuous variables. Likelihood ratios (LR) and 95% confidence intervals (CI) were estimated using a modified Poisson regression with robust error variance to evaluate the relationships between patient-perceived incurability and AD completion. Models were subset for White patients (n = 879), BIPOC patients (n = 330), and patients with solid organ malignancies (n = 987). Models were adjusted for demographics and clinical characteristics. Results: Of 1209 patients, 73% were White, and 82% had solid organ malignancies, most commonly gynecologic (32%), breast (17%), and gastrointestinal (13%). The sample was predominantly female (70%) with early-stage disease (60%) and a median age of 66 (IQR 58-72). AD completion was 46%, 32%, and 41% for patients who were White, BIPOC, or had solid organ malignancies, respectively. In adjusted analyses, patient-perceived incurability was not associated with AD completion for any of the patient subgroups (White LR 1.06, 95% CI 0.89-1.35; BIPOC LR 0.93, 95% CI 0.60-1.44; solid organ LR 1.10, 95% CI 0.88-1.36). Conclusions: Patient-perception of incurability does not appear to be associated with AD completion even in subgroup analyses based on race and ethnicity or cancer type.