{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T11:10:35Z","timestamp":1780657835274,"version":"3.54.1"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,2,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    In Texas, over one million individuals are living with a history of cancer, yet survivorship outcomes remain deeply shaped by inequities in access to digital health technologies. Tools such as telehealth, patient portals, electronic patient\u2010reported outcomes, and interpreter or proxy services have become essential to symptom management, care coordination, and quality of life. However, access and benefits are unevenly distributed. Racial and ethnic minorities, rural residents, those with limited English proficiency, and low\u2010income populations consistently face structural barriers, including limited broadband, device scarcity, and lower digital literacy. Caregivers shoulder substantial, often invisible, burdens by managing portals, troubleshooting devices, and navigating insurance authorizations, compounding inequities. Evidence from Texas highlights these disparities at multiple levels, from county\u2010level broadband and insurance gaps to variable Medicaid coverage. Although initiatives such as the Texas Cancer Plan and Cancer Prevention and funding from the Research Institute of Texas provide critical opportunities, survivorship support is too often delivered as fragmented pilot projects rather than durable infrastructure. The author proposes that survivorship technologies be conceptualized as a baseline\n                    <jats:italic>tech bundle<\/jats:italic>\n                    , including portals, telehealth with interpreter integration, electronic patient\u2010reported outcome, broadband connectivity, devices, caregiver supports, financial navigation tools, and features such as language access and accessibility design. Framing survivorship technology as essential infrastructure, rather than discretionary innovation, shifts the focus from individual uptake to structural design, policy alignment, and sustainability. Doing so would reduce hidden caregiver burdens, close access gaps, and establish survivorship technology as a public good, ensuring that all Texans living after cancer can navigate survivorship with dignity and support.\n                  <\/jats:p>","DOI":"10.1002\/cncr.70310","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T16:30:41Z","timestamp":1771000241000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Public interest technology for cancer survivorship in Texas: A survivorship tech bundle"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2011-4545","authenticated-orcid":false,"given":"George","family":"Kypriotakis","sequence":"first","affiliation":[{"name":"Department of Behavioral Science The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Cancer in Texas 2024","author":"Texas Department of State Health Services","year":"2024"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djad225"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12161569"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2025.108777"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/OP.23.00006"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjonc\u20102024\u2010000432"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764\u2010024\u201001602\u20106"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2019.0034"},{"key":"e_1_2_9_10_1","volume-title":"From Cancer Patient to Cancer Survivor: Lost in Transition","author":"Committee on Cancer Survivorship: Improving Care and Quality of Life; National Cancer Policy Board","year":"2005"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12619"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.2196\/66636"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16132293"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/20552076251326160"},{"key":"e_1_2_9_15_1","volume-title":"From cancer patient to cancer survivor: Lost in transition","author":"Hewitt ME","year":"2006"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(16)30570\u20108"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2015\u20100517"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764\u2010019\u201000740\u20106"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncimonographs\/lgab001"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.2196\/70146"},{"issue":"3","key":"e_1_2_9_21_1","article-title":"Texas Oncology\u2019s Hudson shares how ePROs helped reduce cost of care","volume":"30","author":"Caffrey M","year":"2023","journal-title":"Am J Manag Care"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1200\/CCI.21.00063"},{"key":"e_1_2_9_23_1","volume-title":"State Office of Rural Health (SORH)","author":"Texas Department of Agriculture","year":"2022"},{"key":"e_1_2_9_24_1","unstructured":"Texas Health and Human Services.Telemedicine Telehealth and Home Telemonitoring in Texas Medicaid\u2014Fiscal Year 2022. 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