Disparities in pediatric oncology access and outcomes in the occupied Palestinian territories: a retrospective study from Augusta Victoria Hospital

Background: Childhood cancer survival rates are lower in low- and middle-income countries, with additional challenges in the occupied Palestinian territories (OPT) due to political instability. This study reports outcomes of children treated at Augusta Victoria Hospital (AVH), the only dedicated cancer center in the OPT. Methods: A retrospective chart review analyzing diagnoses, treatments, and outcomes of pediatric oncology patients admitted to AVH between January 2018 and June 2024. Gaza patients had the lowest OS (64.47%) and EFS (38.18%), compared to the West Bank (OS: 81.69%, EFS: 70.77%) and East Jerusalem (77.78%). Interpretation: This study is the first to report on outcomes of pediatric oncology patients treated at AVH. Males and patients older than 10 years experienced longer diagnostic delays, while patients with solid tumors faced treatment delays 15 times longer than those with leukemia. Gaza patients had higher LTFU rates and treatment-related deaths with significantly inferior survival. Funding: No funding was received.