Amornsillaphachai P.Lertvivatpong N.Sirichotiwat K.Narindrarangkura P.Sinlapamongkolkul P.Pakakasama S.Isaranimitkul D.Techavichit P.Chingnawan S.Sripattanatadasakul P.Sathitsamitphong L.Winaichatsak A.Takpradit C.Sudnawa K.K.Suwannaying K.Monsereenusorn C.Mahidol University2026-04-292026-04-292026-06-01Pediatric Blood and Cancer Vol.73 No.6 (2026)15455009https://repository.li.mahidol.ac.th/handle/123456789/116368Purpose: In low- and middle-income countries, including Thailand, pediatric cancer survivorship care is limited by resource constraints, lack of structured programs, and an overemphasis on recurrence surveillance. Understanding healthcare provider (HCP) perceptions is a key first step toward developing sustainable multidisciplinary survivorship guidelines. Methods: The Doctor Assessment in Late-Effects Treatment (DALET) survey was used to assess HCPs’ perceptions of late-effect care. The survey was distributed nationwide to physicians involved in childhood cancer care using a targeted dissemination strategy guided by local experts. Results: A total of 114 physicians from 37 centers participated, with only 3 centers (8.1%) having dedicated late-effect clinics. Most respondents (69.3%) reported prior training in late-effect care, and 81.6% provided post-treatment follow-up. Overall knowledge showed good alignment with the Children's Oncology Group Long-Term Follow-Up Guidelines (mean score, 71.7%), with prior training independently associated with higher alignment (p = 0.034). Confidence in managing physical late effects was significantly associated with physician expertise (p < 0.001), hospital type (p = 0.036), and prior training (p < 0.001), while access to consultation varied by expertise and hospital type. Main barriers to late-effect clinics were a lack of one-stop multidisciplinary services (80.7%) and time constraints (78.9%). Conclusions: Gaps in training and confidence persist across specialties and institutions, highlighting the need for national policies that strengthen education, capacity building, multidisciplinary collaboration, and standardized guidelines to ensure equitable late-effect care for pediatric cancer survivors in Thailand.MedicineArticleSCOPUS10.1002/1545-5017.702732-s2.0-1050364235231545501741889292