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 on 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 government agency in the United States of child sexual abuse in the Catholic Church. There have been ten 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.”