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Life sciences · Journal article
Indonesian Journal of Cancer · September 30, 2026
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Background: Childhood cancer is a major global health burden, with survival rates exceeding 80% in high-income countries (HICs) but remaining substantially lower in low- and middle-income countries (LMICs). Treatment abandonment is a key contributor to this disparity. In Indonesia, particularly outside Java, data on treatment abandonment are limited. This study aimed to determine the proportion, temporal trends, reasons for abandonment, time to abandonment, and demographic characteristics associated with abandonment among pediatric cancer patients at Dr. M. Djamil General Hospital, Padang, West Sumatra. Methods: A retrospective descriptive study was conducted using data from the Indonesian Pediatric Cancer Registry (IPCAR) at Dr. M. Djamil Central General Hospital, Padang. The study included all pediatric oncology patients admitted between January 2022 and December 2024. Reasons for treatment abandonment were obtained through follow-up telephone interviews with parents in July 2025. Demographic and clinical variables were analyzed descriptively, while temporal trends were assessed using the Chi-square test for linear trend. Treatment abandonment was defined as discontinuation of curative therapy for ≥4 weeks without any medically justified reason. Results: Among the 367 patients, 57 (15.5%) experienced treatment abandonment, with the rate significantly decreasing from 23.9% in 2022 to 12.1% in 2024. Abandonment was more common in children aged 1–10 years and those above 10 years, those residing outside Padang City, and those diagnosed with hematolymphoid tumors. Financial constraints were the most frequently reported reason for abandonment (33.3%). Most abandonment events (84.2%) occurred within the first six months following diagnosis, with a median time to abandonment of 96 days. Conclusion: Treatment abandonment in pediatric cancer in our center is declining over the three years yet remains a critical challenge. Targeted interventions in the early treatment phase, improved follow-up systems, and strategies to reduce financial constraints and practical access issues are urgently needed to improve adherence and survival.