Send to

Choose Destination
See comment in PubMed Commons below
BMJ Case Rep. 2017 Jun 3;2017. pii: bcr-2017-219289. doi: 10.1136/bcr-2017-219289.

A 15-year-old Nepali boy with metastasised colorectal cancer.

Author information

The Medical School for International Health, Ben-Gurion University of the Negev Faculty of Health Sciences, Beer Sheva, Israel.
Surgery Ward A, Soroka University Medical Center, Beer Sheva, Israel.
Department of Epidemiology and Health Evaluation, Ben-Gurion University of the Negev Faculty of Health Sciences, Beer Sheva, Israel.


Nepal suffers from vast inequalities in modern healthcare. The low-income country wrestles with far-reaching insufficiencies in minimal preventative medicine, health awareness, limited infrastructure and difficult topography-all of which contribute to poor access and poor care-seeking behaviour. Our patient came from rural Nepal, where primary healthcare outposts are frequently understaffed and underequipped. He received supportive treatment in his village from the time symptoms presented until he was diagnosed 2 years later, at a tertiary medical centre, with colorectal cancer. An examination of the relevant literature indicates that younger patients often present in later stages of the disease due to initial misdiagnosis or overlooking colorectal cancer as a possibility. Beyond the rarity of the patient's condition, the logistical and financial obstacles he faced in Nepal, particularly outside of the capital of Kathmandu, deterred his access to a higher level of care and delayed his correct diagnosis and treatment.


Cancer; Endoscopy; GI bleeding; Global Health; Medical education


Conflict of interest statement

Competing interests: None declared.

PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire
    Loading ...
    Support Center