Pediatr Blood Cancer 2010;54:721–727 Access to Specialized Pediatric Cancer Care in Switzerland Martin Adam, MSc,1 Nicolas von der Weid, MD,2 Gisela Michel, PhD,1 Marcel Zwahlen, PhD,1 Jean-Michel Lutz, PhD,3 Nicole Probst-Hensch, PhD,4 Felix Niggli, MD,5 and Claudia Kuehni, MD1* for the Swiss Pediatric Oncology Group (SPOG){ and for the Swiss Association of Cancer Registries (ASRT){ Background. Specialized pediatric cancer centers (PCCs) are thought to be essential to obtain state-of-the-art care for children and adolescents. We determined the proportion of childhood cancer patients not treated in a PCC, and described their characteristics and place of treatment. Procedure. The Swiss Childhood Cancer Registry (SCCR) registers all children treated in Swiss PCCs. The regional cancer registries (covering 14/26 cantons) register all cancer patients of a region. The children of the SCCR with data from 7 regions (11 cantons) were compared, using specialized software for record linkage. All children <16 years of age at diagnosis with primary malignant tumors, diagnosed between 1990 and 2004, and living in one of these regions were included in the analysis. Results. 22.1% (238/1,077) of patients recorded in regional registries were not Key words: registered in the SCCR. Of these, 15.7% (169/1,077) had never been in a PCC while 6.4% (69/1,077) had been in a PCC but were not registered in the SCCR, due to incomplete data flow. In all diagnostic groups and in all age groups, a certain proportion of children was treated outside a PCC, but this proportion was largest in children suffering from malignant bone tumors/soft tissue sarcomas and from malignant epithelial neoplasms, and in older children. The proportion of patients treated in a PCC increased over the study period (P < 0.0001). Conclusions. One in six childhood cancer patients in Switzerland was not treated in a PCC. Whether these patients have different treatment outcomes remained unclear. Pediatr Blood Cancer 2010;54:721–727. ß 2010 Wiley-Liss, Inc. adolescents; cancer center; health care provider/services; quality of care