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Disparities in pediatric oncology access and outcomes in the occupied Palestinian territories: a retrospective study

Ru'a Rimawi1,2, Kendall Carpenter3, Wesam Taleb4

  • 1Science Health Education Center, Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA, USA.

Eclinicalmedicine
|November 3, 2025
PubMed

Insights

Childhood cancer survival is lower in low-income countries. This study at Augusta Victoria Hospital (AVH) in the occupied Palestinian territories (OPT) found significant delays and lower survival rates for children in Gaza compared to the West Bank and East Jerusalem.

Area of Science:

  • Pediatric Oncology
  • Global Health Disparities
  • Cancer Care in Conflict Zones

Background:

  • Childhood cancer survival rates are significantly lower in low- and middle-income countries.
  • The occupied Palestinian territories (OPT) face unique challenges in pediatric cancer care due to political instability.
  • Augusta Victoria Hospital (AVH) is the sole dedicated cancer center serving pediatric patients in the OPT.

Purpose of the Study:

  • To report on the treatment outcomes of pediatric oncology patients at Augusta Victoria Hospital (AVH).
  • To identify factors influencing diagnostic and treatment delays in pediatric cancer patients within the OPT.
  • To analyze survival rates and identify disparities in pediatric cancer care across different regions of the OPT.

Main Methods:

  • Retrospective chart review of pediatric oncology patients admitted to AVH from January 2018 to June 2024.
  • Analysis included patient demographics, diagnoses, treatment timelines, and survival outcomes.
  • Data stratified by region (West Bank, Gaza, East Jerusalem), gender, age, and cancer type.

Main Results:

  • A total of 424 pediatric cancer patients were analyzed, with variations in diagnostic and treatment delays based on gender, age, and diagnosis.
  • Patients from Gaza experienced higher rates of loss to follow-up (LTFU) and treatment-related deaths, primarily due to infection.
  • Three-year overall survival (OS) was 76.99% and event-free survival (EFS) was 62.91%, with significantly lower survival rates observed in Gaza patients (OS: 64.47%, EFS: 38.18%).

Conclusions:

  • This study highlights significant delays in diagnosis and treatment for pediatric cancer patients in the OPT, particularly for males and older children.
  • Patients with solid tumors faced considerably longer treatment delays compared to those with leukemia.
  • Gaza patients exhibited poorer outcomes, including higher LTFU rates, increased treatment-related mortality, and significantly reduced survival rates, underscoring critical regional disparities in pediatric cancer care.
Abstract

Keywords:
ConflictGlobal healthPediatric oncologyResource-limited

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