Background: Childhood cancer deaths may be associated with persistent parental grief. Evidence on grief symptoms beyond ten years post-loss remains limited.

Aims: We described grief symptoms, identified grief profiles, and examined associations between grief intensity and sociodemographic, cancer-related characteristics, and time since death.

Design: This multicenter cross-sectional survey was conducted in Switzerland (July 2022-July 2023). We used PG-13. Items were rated on a 5-point scale (1-5). We calculated the sum score to assess grief intensity (range 11-55). We employed descriptive statistics, latent profile analysis, and linear regression analyses.

Setting/participants: Eligible parents had a child diagnosed with cancer (⩽18 years), who had received treatment at one of three participating Swiss pediatric oncology centers and had died ⩾1 year prior to study participation. Participants were identified via the Swiss Childhood Cancer Registry and invited by the child's former treatment facility.

Results: Of 388 identified cases, 103 parents of 81 deceased children participated. Mean grief intensity was 23.3 (SD = 9.0); yearning represented the most prominent symptom (mean = 3.2), while reminder avoidance was least prominent (mean = 1.3). Latent profile analysis revealed three grief profiles: low (56%), moderate (32%), and high grief (12%). High poverty risk (β = 11.04, p<0.001) and death in healthcare facility (β = 3.82, p  = 0.024) were associated with higher grief intensity, while longer time since death was associated with lower grief intensity (β = -5.46, p  = 0.041).

Conclusions: Parental grief symptoms can persist long after the death of a child to cancer. Integrated palliative care, anticipatory guidance, and multidisciplinary collaboration may identify at-risk parents early, and ensure sustained support within the community.