Bishops and other leaders of the Roman Catholic Church in Pennsylvania covered up child sexual abuse by more than 300 priests over a period of 70 years, persuading victims not to report the abuse and police officers not to investigate it, according to a report issued by a grand jury Tuesday.

The report, which covered six of the state's eight Catholic dioceses and found more than 1,000 identifiable victims, is the broadest examination yet by a U.S. government agency of child sexual abuse in the Catholic Church. There have been 10 previous reports by grand juries and attorneys general in the United States, according to the research and advocacy group BishopAccountability.org, but those examined single dioceses or counties.

The report catalogs horrific instances of abuse, including a priest who raped a young girl in the hospital after she had her tonsils out, and another priest who was allowed to stay in ministry after impregnating a 17-year-old girl, forging a signature on a marriage certificate and then divorcing the girl.

“Despite some institutional reform, individual leaders of the church have largely escaped public accountability,” the grand jury wrote. “Priests were raping little boys and girls, and the men of God who were responsible for them not only did nothing; they hid it all. For decades.”

The grand jury added that the church officials named in their report have been protected and some have been promoted. “Until that changes, we think it is too early to close the book on the Catholic Church sex scandal,” the jury wrote.

The report said that church officials followed a “playbook for concealing the truth:” minimize the abuse using words like “inappropriate contact” instead of “rape”; assign priests untrained in sexual abuse cases to investigate their colleagues; when removing an accused priest, don’t inform the community of the real reasons.

“Tell his parishioners that he is on ‘sick leave,’ or suffering from ‘nervous exhaustion.’ Or say nothing at all,” the report said.

Attorney General Josh Shapiro, whose office conducted the investigation, said in a news conference, “They protected their institution at all costs. As the grand jury found, the church showed a complete disdain for victims.”

Victims expressed relief that Shapiro and his agents had conducted the investigation after the victims’ efforts to get church officials to take action went nowhere.

“I had gone to two bishops with allegations over five years, and they ignored and downplayed my allegations,” said the Rev. James Faluszczak, an Erie priest on extended leave who was abused as a child and who testified before the grand jury. “It’s that very management of secrets that has given cover to predators.”

In statements released on Tuesday, Pennsylvania’s Catholic bishops called for prayers for victims and for the church, promised greater openness and said that measures instituted in recent years were already making the church safer.

“The Diocese of Erie will not shroud abusers in secrecy — no matter who they are or how long ago the abuse occurred,” Bishop Lawrence Persico said in a statement. “We acknowledge the abuses of the past and are committed to being transparent with our decisions going forward.”

There has been no comprehensive measurement of the full scope of child sexual abuse in the Catholic Church in the United States, though some have tried. American abuse survivors have pushed for years for the government to undertake a nationwide inquiry similar to the one conducted in Australia, where a royal commission spent four years examining the sexual abuse of children by a variety of religious and civic institutions, including the Catholic Church.

The Pennsylvania grand jury report comes as the sex abuse scandal in the church has reached a new stage, with calls to discipline bishops who sexually abused younger priests and seminarians, or who have covered up for abusive colleagues.

Catholics are calling for independent investigations into why Cardinal Theodore McCarrick, the former archbishop of Washington, D.C., was advanced up the hierarchy despite warnings to his superiors in Rome and fellow bishops that he had molested seminarians and young priests. McCarrick resigned in July over allegations of sexually abusing minors, but since then priests in the diocese of Lincoln, Nebraska, and seminarians in Boston and elsewhere have publicly accused their superiors of turning a blind eye to sexual misconduct.

The Pennsylvania grand jury met for two years, reviewed 500,000 documents from dioceses’ secret archives and heard testimony from dozens of victims and the bishop of Erie. The report covers the dioceses of Allentown, Erie, Greensburg, Harrisburg, Pittsburgh and Scranton. Two of the dioceses — Greensburg and Harrisburg — tried to quash the grand jury investigation last year, but later backed off that stance.

No other state has seen more grand jury investigations of abuses in the church than Pennsylvania, where about 1 of every 4 residents is Catholic and the local attorneys general have been particularly responsive to victims. Previous grand juries examined the dioceses of Philadelphia and Altoona-Johnstown; the new report covers the rest of the state.

The report lists each of the accused priests and documents how they were sent from parish to parish, and even sometimes out of state. The grand jury said that while the list is long, “we don’t think we got them all.” The report added, “We feel certain that many victims never came forward, and that the dioceses did not create written records every single time they heard something about abuse.”

Only two of the cases in the report have led to criminal charges; in the others, the statute of limitations had expired.

In the Greensburg diocese, the Rev. John Sweeney was charged by the attorney general’s office with sexually abusing a boy in the early 1990s. Sweeney pleaded guilty this month and awaits sentencing. In the Erie diocese, the Rev. David Poulsson was arrested in May and charged with sexually assaulting a boy for eight years, starting at age 8. Poulsson has yet to enter a plea.

The state legislature has so far resisted calls to lift the statute of limitations, which has prevented childhood victims from filing lawsuits against the church after they turn 30. For many victims, it has taken decades to gain the courage to speak about the abuse, long past when the law would allow them to sue.

The grand jury strongly recommended that the statute of limitations be extended in criminal cases. For civil lawsuits, they recommended opening a temporary “window” that would permit older victims to file suits against perpetrators, and the church.

The church has lobbied against any change to the statute or to open such a window, with its effort led by Bishop Ronald W. Gainer of Harrisburg, president of the Pennsylvania Catholic Conference. But abuse survivors and advocates say that in September they plan to begin a fresh campaign to press lawmakers and Gainer to drop their opposition.

“If this doesn’t start a serious debate on the elimination of the statute of limitation, there’s something seriously wrong with my fellow Pennsylvanians,” said Shaun Dougherty, 48, who testified before the Altoona-Johnstown grand jury about being abused by a priest for three years starting at age 10.

About two dozen people named in the report petitioned the court to have their names redacted from it.

In the news conference, Shapiro, the attorney general, described the “intense legal battle” that played out over the last several months as some people named in the report appealed to the Pennsylvania Supreme Court to block its release.

“They wanted to cover up the cover-up,” he said.

Shapiro said his office would continue to fight for a full version of the report to be released with no redactions.

One example of a cover-up detailed in the report concerns the Rev. Ernest Paone, a priest who was caught molesting young boys and using guns with even younger children in Pittsburgh. A fellow pastor intervened in 1962 to stop the police from arresting him. The district attorney at the time, Robert Masters, wrote to the diocese in 1964 to say that he had halted his investigation of the case “in order to prevent unfavorable publicity” for the diocese.

In testimony before the grand jury, Masters said that he had wanted the church’s support for his political career.

Paone was relocated successively to Los Angeles, San Diego and Reno, Nevada, in the following years, with Pittsburgh’s bishops attesting to his fitness as a priest. Among the bishops was Cardinal Donald Wuerl, now the archbishop of Washington. He accepted Paone’s resignation from ministry in good standing in 2003, allowing him to collect his pension.

Wuerl released a letter to his priests on Monday, saying that while the grand jury report would be “critical of some of my actions, I believe the report also confirms that I acted with diligence, with concern for the survivors and to prevent future acts of abuse.”

The dioceses of Allentown, Greensburg, Pittsburgh and Scranton have pledged that once the grand jury report was released, they would release the names of all priests in their dioceses who are accused of sexually abusing minors. The Erie and Harrisburg dioceses have already posted lists of accused priests on their websites.

Gainer in Harrisburg recently ordered that the names of accused priests and of bishops who mishandled abuse cases be taken down from all church buildings in the diocese.

The report says that one of the victims who had testified before the grand jury tried to kill herself while they were deliberating.

“From her hospital bed, she asked for one thing,” the grand jury wrote in the report, “that we finish our work and tell the world what really happened.”

This article originally appeared in The New York Times.

Laurie Goodstein and Sharon Otterman © 2018 The New York Times