Childhood cancer care in Italy faces significant disparities in access and outcomes, prompting concerns about equitable healthcare delivery. Recent reports highlight a troubling trend of families needing to travel long distances, even across regional boundaries, to access specialized treatment centers. This “healthcare migration,” as it’s termed, underscores systemic challenges within the Italian healthcare system.
A study published in in the Italian Journal of Pediatrics investigated healthcare migration patterns among children with cancer. Researchers found that families often seek care at specific centers within the Italian Association of Pediatric Hematology and Oncology (AIEOP) network, even if it means relocating temporarily or traveling frequently. This migration isn’t necessarily indicative of dissatisfaction with local care, but rather a pursuit of specialized expertise and potentially better survival rates available at larger, more established centers.
The reasons behind this phenomenon are complex. A qualitative study published in in Cancer Control, identifies barriers and needs of cancer patients and healthcare providers in Italy. The study points to disparities in the level of care available across different communities, hospitals, and regions. While progress has been made in cancer treatment these advancements aren’t uniformly distributed, leading families to seek out centers with proven track records and specialized programs.
Survival rates for childhood cancer in Italy are generally positive. Data indicates that 5-year survival has reached 85% for children and 89% for adolescents. However, these figures mask underlying inequalities. The need to migrate for treatment places a substantial burden on families, both emotionally and financially. Relocation disrupts daily life, schooling, and employment, adding stress to an already difficult situation.
The issue isn’t limited to access to treatment; it also extends to the quality of palliative care. As noted by Luca Manfredini, an oncologist at the Gaslini Institute in Genoa, there’s a common misconception that pediatric palliative care is solely end-of-life care. In reality, it’s an integral part of the care continuum, focused on improving quality of life for children and families facing serious illness, and should be available throughout the course of the disease.
Several Italian hospitals are dedicated to providing comprehensive cancer care for children. The IRCCS Azienda Ospedaliero-Universitaria Di Bologna, the Bambino Gesù Pediatric Hospital in Rome, the Istituto Nazionale Dei Tumori in Milan, the Padua University Hospital, and the Istituto Giannina Gaslini in Genoa are all mentioned as key centers involved in research and treatment. The Lalla Seràgnoli Pediatric Oncology and Hematology Unit in Bologna, for example, has been a focal point for research into healthcare migration patterns.
The Burlo Garofolo Institute in Trieste has treated over 1000 children with cancer over the past 40 years, demonstrating a long-standing commitment to pediatric oncology. Beyond medical treatment, support systems are emerging to help children cope with the challenges of illness. One example is the provision of educational support, allowing children to continue their studies even while undergoing treatment, helping them maintain a sense of normalcy.
Addressing these disparities requires a multi-faceted approach. Improving the distribution of specialized expertise across all regional centers is crucial. This could involve investing in training programs for healthcare professionals, establishing collaborative networks between hospitals, and implementing standardized treatment protocols. Providing financial and logistical support to families who must travel for treatment is essential to alleviate the burden of healthcare migration.
The Italian healthcare system is actively working to address these challenges. The AIEOP plays a central role in coordinating care and promoting research. However, ongoing monitoring and evaluation are needed to ensure that all children in Italy have equitable access to high-quality cancer care, regardless of their geographic location or socioeconomic status. Further research is needed to fully understand the long-term impact of healthcare migration on families and to identify effective strategies for reducing disparities in outcomes.
