OBJECTIVES: An estimated 70% of the Brazilian population is covered exclusively by the public healthcare system; consequently, many patients with cancer must rely on few public institutions for oncology care. This study investigated the impact of insurance type on access, health-related quality of life (HRQoL), mood and sleep related outcomes for real-world cancer patients in Brazil.   METHODS: Data came from the 2011 (n=12,000), 2012 (n=12,000), & 2014 (n=9,082) Brazil National Health and Wellness Survey, an internet-based general health survey representative of the general population in age and gender. Among 33,082 respondents, 1,019 reported a cancer diagnosis. Respondents were categorized into public insurance (n=405) or private insurance (n=614). Initial analyses used one-way ANOVAs and chi-squares, and generalized linear models were used to control for demographic and health characteristics (e.g., income) to isolate differences in HRQoL, mood and sleep disorders, and healthcare resource use according to insurance type. RESULTS: Those with private insurance were more likely to be white (76.9%), have completed their degree (57.5%), have annual household income ≥R$6501 (49.8%), be obese (23.9%), and drink alcohol (69.4%). Those on private insurance were also more likely to report having generalized anxiety disorder (9.0% vs. 4.7%) and overall sleep issues (50.2% vs. 43.5%) than those on public insurance. After controlling for covariates, those with private insurance reported a higher mean number of doctor visits (9.87 vs. 6.58), emergency room visits (1.05 vs. 0.57), and hospitalizations (0.54 vs. 0.32). There were no differences on HRQoL. CONCLUSIONS: Lower resource use among those on the public system indicates disparities in healthcare access among cancer patients in Brazil. HRQoL was not associated with insurance type, while mood and sleeping disorders were more common among those with private insurance. Further research is needed to understand why inequality of access is not reflected in HRQoL decrements in this population.