Advancing Equity in Pediatric and AYA Oncology: From Precision Diagnostics to Survivorship and Global Health

Outcomes for children, adolescents, and young adults (AYA) with cancer are shaped as much by geography, income, and health system capacity as by tumor biology. Across the care continuum, three inequities stand out: unequal access to timely and precise diagnosis; absent or fragmented survivorship care; and a global divide that compounds both, especially in low- and middle-income countries (LMICs) and underserved communities.AYA patients are particularly exposed. Their cancers sit between pediatric and adult diagnostic frameworks, atypical presentations drive longer delays, and access to molecular characterization, clinical trials, and survivorship infrastructure is consistently sparser than for younger children — inequities that remain largely unaddressed by the broader literature.This Research Topic invites research grounded in pediatric and AYA oncology outcomes (survival, disease control, toxicity, late effects, quality of life) that interrogates the biological, clinical, and structural drivers of inequity — and, critically, moves beyond describing disparities toward evidence-based interventions: scalable solutions using genomics, real-world data, telemedicine, and community engagement to build sustainable, culturally adaptive care pathways. The goal is actionable evidence capable of shaping practice and policy at local, national, and global levels.Areas covered include, but are not limited to:- Diagnostic delay and the AYA diagnostic gap: determinants, clinical and biological consequences, and interventions that reduce time to diagnosis — with particular attention to the atypical presentations and framework gaps driving longer delays in AYA patients.- Access to precision diagnostics: real-world implementation and clinical impact of genomic profiling, molecular subtyping, liquid biopsy, and advanced biomarkers in LMICs and underserved populations, including scalable delivery models.- Equity in risk-adapted treatment and outcomes: the impact of race, ethnicity, socioeconomic status, geography, and health system structure on treatment access, abandonment, toxicity burden, and survival.- Global survivorship and late-effects equity: the distribution of late effects and psychosocial sequelae by geography, income, and ethnicity; barriers to long-term follow-up; and scalable models for delivering survivorship care where specialist infrastructure is limited or absent.- Scalable delivery models for equitable care: twinning programs, capacity building, telemedicine, digital health, and community-based and culturally adaptive approaches, evaluated by their impact on diagnosis timing, treatment adherence, and access to survivorship care.Please note that manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases that are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of the scope of this Research Topic. Topic editors: Luca Lo Nigro, Natacha ENTZ-WERLE Source: https://www.frontiersin.org/research-topics/80050/advancing-equity-in-pediatric-and-aya-oncology-from-precision-diagnostics-to-survivorship-and-global-health