Pope Francis has vowed to end clerical sexual abuse, but bishops from Asia and Africa have shown a mixed response to a scandal some have termed a "Western problem".
Church leaders from around the world attended the closing mass Sunday of a month-long meeting, or synod, which many had hoped would take the global struggle against paedophile priests up a notch.
As the talks began, Francis warned again that abuse and cover ups would not be tolerated.
But as US Cardinal Blase Joseph Cupich told the press, priestly sexual abuse was "not on the front burner of all countries".
"The resistance of some bishops" to discuss a crisis which has hit countries from Germany to America and Chile limited talk time at the synod, US Archbishop of Philadelphia Charles Chaput told the Catholic News Service agency.
"Some say that (sex abuse) really is an issue of the Western world," he said, adding that he wished that "we had spent more time not only talking about (the crisis), but apologizing to people for it".
Eamon Martin, the President of the Irish Episcopal Conference, said some churches were "in denial" and had not given the anti-paedophilia campaign "its proper place".
He said hopes now lay in an exceptional meeting convened in late February by the pope at which the heads of bishop conferences from around the world are to discuss the protection of minors.
Martin said he prayed the meeting "will help to ensure that more countries will take this issue seriously".
The Vatican has already warned that in some countries the church is dragging its feet because of cultural difference over what constitutes child abuse.
The problem was particularly serious in Asia, Archbishop Charles Scicluna -- a former top prosecutor on paedophile priest cases -- said in 2012 on the sidelines of an international conference on the crisis at the religious Gregorian University.
Scicluna, who recently carried out an abuse probe in Chile, said earlier this month that church leaders must realize this is not "a problem linked to any culture or geographic part of the world.
"That is a myth that has to be dispelled," he said.
Cardinal Reinhard Marx, head of the German bishops' conference, agreed that "the subject is present all over the whole world".
"It's an urgent situation. It's a matter of survival for the church, at least in its current form," he warned.
Germany's Catholic church apologised last month to thousands of victims of sexual assault by clergy, with Marx insisting that perpetrators must be brought to justice.
Apologies, he said on the sidelines of the synod, were not enough: the Roman Catholic Church must also "fundamentally change the system" with the help of new prevention mechanisms.
He called for "a new canon law in all aspects", given that the current version dates back to 1983.
Marx said there were too few staff in the Vatican -- around 10 people -- to examine reports of cleric abuse from all around the world.
Hans Zollner, head of the Vatican's Child Protection Centre, said meanwhile that the definition of child abuse was too vague.