BACKGROUND: Candidiasis in cancer patients remains largely unexplored in China. This study examines risk factors and antifungal susceptibility patterns of in cancer patients from Jiangxi, China. METHODS: Clinical and demographic data on in cancer patients (2018-2024) were retrospectively collected at Jiangxi Cancer Hospital, Nanchang, China. distribution across cancers and antifungal susceptibility patterns were analyzed. Risk factors were identified via logistic regression, and antifungal consumption was correlated with distribution. Survival probabilities were compared between patients with and those with non- (NAC) infections. RESULTS: Among 2,761 isolates, 1,703 (61.68%) were and 1,058 (38.31%) were NAC, with a year-wise trend showing a decline in and a rise in NAC. was significantly higher in lung (40.57%) and nasopharyngeal (11.33%) cancers, while NAC were more common in gastric (7.56%), colon (8.69%), and urogenital (14.65%) cancers. NAC risk factors included inappropriate empirical therapy (OR 13.8, < 0.001), hypoproteinemia (OR 1.35), anemia (OR 1.28), urinary tract infection (OR 1.71), and indwelling catheters (OR 1.27) (all < 0.05). Radiotherapy, targeted therapy, glucocorticoids, chest tube insertion, and parenteral nutrition were associated with ( ≤ 0.01). Amphotericin B (>99%) and echinocandins (>96%) showed the highest efficacy. displayed notable azole resistance (40.9-74.45%). Caspofungin use negatively correlated with ( = -0.84, = 0.02) and positively with ( = 0.78, = 0.04) and ( = 0.85, = 0.02). NAC infections showed 1.5-fold higher mortality rate than (95% CI: 1.1-2.0; = 0.0075). CONCLUSION: These findings may aid healthcare officials in improving management in the region and similar settings.