Background <p>As digital health technologies become increasingly integrated into cancer care, older cancer patients are becoming important users of digital healthcare services. However, technophobia may limit their effective engagement with digital health services. Evidence regarding the heterogeneity of digital health-related technophobia and its influencing factors among older cancer patients remains limited.</p> Objective <p>To identify distinct profiles of digital health-related technophobia among older cancer patients and to examine factors associated with profile membership.</p> Methods <p>A cross-sectional study was conducted between November 2023 and July 2024 among 307 older cancer patients from a tertiary hospital in Shandong, China. Participants completed the Technophobia Scale, eHealth Literacy Scale, and General Self-Efficacy Scale. Latent profile analysis was used to identify technophobia profiles, and multinomial logistic regression was used to examine associated factors.</p> Results <p>Three technophobia profiles were identified: Low Technophobia (50.2%), Moderate Technophobia with Techno-Anxiety (19.2%), and High Technophobia (30.6%). Using the Low Technophobia group as the reference, multinomial logistic regression showed that smartphone use was associated with higher odds of belonging to the Moderate Technophobia with Techno-Anxiety group (OR = 5.26, 95% CI: 1.87–14.78). In contrast, caregiver smartphone use, prior online health information seeking, and engagement with the hospital’s WeChat account were associated with lower odds of membership in this group (all <i>P</i> &lt; 0.01). Additionally, lower general self-efficacy was associated with higher odds of belonging to the High Technophobia group (<i>P</i> = 0.014).</p> Conclusion <p>Technophobia among older cancer patients is heterogeneous. Targeted interventions addressing not only access to technology, but also psychological readiness and social support, may help reduce digital inequities in cancer care.</p>