Identifying the Factors Contributing to Treatment Abandonment in Childhood Cancers at a Tertiary Care Hospital in Pakistan

Background: Despite advances in pediatric cancer treatment, survival rates in low-and middle-income countries (LMICs), such as Pakistan, remain low.Treatment abandonment, driven primarily by socioeconomic barriers and limited access to specialized care, is a leading cause of poor outcomes.This study aimed to identify factors associated with treatment abandonment among pediatric cancer patients.Methodology: This prospective cohort study was conducted at the Pediatric Oncology Department, The Children's Hospital, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from January to December 2024.A total of 104 pediatric cancer patients aged < 14 years were included.Baseline interviews were conducted with parents to assess demographic and treatment-related factors at the time of diagnosis.Follow-up interviews were conducted to identify reasons for treatment abandonment, along with perceived challenges during treatment.Results: Among 104 patients, 18 (17.3%)abandoned treatment, while 86 (82.7%) adhered to it.Common challenges included long travel distances (60.6%) and frequent hospital visits (82.7%).The leading reasons for abandonment were financial difficulties (61.1%) and geographical barriers (16.7%).Lower maternal education and the presence of treatment-related side effects were significantly associated with abandonment (p < 0.05).Male patients had higher compliance (61.6%) than females (38.4%).Patients diagnosed with solid tumors (38.9%) and leukemia (33.3%) indicated the highest abandonment rates.Most patients (63.4%) tolerated treatment well, and 66.3% perceived it as highly effective.