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.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Editorial
• FAIR² Data
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Editorial
• FAIR² Data
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Systematic Review
• Technology and Code

Keywords: Pediatric oncology, Adolescent and young adult oncology, Diagnostic delay, Health equity, Precision diagnostics, Molecular characterization, Low- and middle-income countries, Cancer disparities, Survivorship care, Genomic profiling

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.