Many of the priests are dead or retired, while others have been dismissed from the priesthood or put on leave.
"We are sick over all the crimes that will go unpunished and uncompensated," the grand jury said.
Authorities evaluated each suspect and were able to charge just two, including a priest who has since pleaded guilty. Shapiro said the investigation is ongoing.
The grand jury accused Cardinal Donald Wuerl, who leads the Washington archdiocese, of helping to protect abusive priests when he was Pittsburgh's bishop. Wuerl, who led the Pittsburgh diocese from 1988 to 2006, disputed the allegations.
"While I understand this report may be critical of some of my actions, I believe the report confirms that I acted with diligence, with concern for the victims and to prevent future acts of abuse," he said.
"I sincerely hope that a just assessment of my actions, past and present, and my continuing commitment to the protection of children will dispel any notions otherwise made by this report."
The grand jury scrutinized abuse allegations in dioceses that minister to more than half the state's 3.2 million Catholics. Its report echoed the findings of many earlier church investigations around the country in its description of widespread sexual abuse by clergy and church officials' concealment of it.
Most of the victims were boys, but girls were abused, too, the report said.
- The abuse ranged from groping and masturbation to anal, oral and vaginal rape.
- One boy was forced to say confession to the priest who sexually abused him.
- A 9-year-old boy was forced to perform oral sex and then had his mouth washed out with holy water.
- Another boy was made to pose naked as if being crucified and then was photographed by a group of priests who Shapiro said produced and shared child pornography on church grounds.
The grand jury concluded that a succession of Catholic bishops and other diocesan leaders tried to shield the church from bad publicity and financial liability.
They failed to report accused clergy to police and sent abusive priests to so-called "treatment facilities," which "laundered" the priests and "permitted hundreds of known offenders to return to ministry," the report said.
The cover-up extended beyond church grounds. The grand jury said it found cases in which police or prosecutors learned of clergy sex abuse allegations but did not investigate out of deference to church officials.
The grand jury's report comes at a time of renewed scrutiny and fresh scandal at the highest levels of the US Catholic Church.
Pope Francis stripped 88-year-old Cardinal Theodore McCarrick of his title and ordered him to a lifetime of prayer and penance amid allegations that McCarrick had for years sexually abused boys and had sexual misconduct with adult seminarians.
Wuerl has come under harsh criticism over his response to the McCarrick scandal, with some commentators questioning his claims of surprise and ignorance over allegations that McCarrick molested and harassed young seminarians.
Wuerl replaced McCarrick as Washington's archbishop after McCarrick retired in 2006.
The Pennsylvania grand jury, convened by the state attorney-general's office in 2016, heard from dozens of witnesses and reviewed more than a half-million pages of internal documents from the Allentown, Erie, Greensburg, Harrisburg, Pittsburgh and Scranton dioceses.
The Pittsburgh diocese said a few priests are still in ministry because the diocese determined allegations against them were unsubstantiated.
Tim Lennon, the president of the Survivors Network of those Abused by Priests, urged Pennsylvania lawmakers to lift civil and criminal statutes of limitations for child sex crimes, and to provide victims who no longer meet the age requirements in state law with a new window to file civil lawsuits.
Some current and former clergy named in the report went to court to prevent its release, arguing it violated their constitutional rights. The state Supreme Court said the public had a right to see it, but ruled the names of priests and others who objected to the findings would be blacked out pending a September hearing on their claims.
Twenty of the grand jurors said they objected to "any attempts to censor, alter, redact or amend" the report.
Several dioceses decided to strip the accused of their anonymity and released the names of clergy members who were accused of sexual misconduct.
- AP
