Barriers to Equitable Pediatric Oncologic Care in the United States

Although survival rates for pediatric cancer diagnoses have improved significantly, persistent health disparities prevent many children and adolescents in the United States from reaping equitable benefit from this progress. This review examines inequities related to race and ethnicity, language preference, socioeconomic status, and geographic location. A literature search identified 33 articles highlighting how these factors intersect to affect diagnosis, treatment access, clinical trial participation, and outcomes. Black patients and Hispanic patients face consistently poorer survival, while language barriers are linked to delayed care and increased mortality. Low socioeconomic status and lack of insurance contribute to late-stage diagnoses and treatment nonadherence. Residence in rural areas or historically marginalized urban neighborhoods are associated with increased mortality. Disparities in clinical trial enrollment further limit access to cutting-edge therapies and weaken the generalizability of research. Addressing these disparities requires systemic reform, culturally informed care, and inclusive research practices to ensure equitable outcomes.