Article Text

Download PDFPDF
A 15-year-old Nepali boy with metastasised colorectal cancer
  1. Chloe Pinto1,
  2. Zvi Howard Perry2,3
  1. 1 The Medical School for International Health, Ben-Gurion University of the Negev Faculty of Health Sciences, Beer Sheva, Israel
  2. 2 Surgery Ward A, Soroka University Medical Center, Beer Sheva, Israel
  3. 3 Department of Epidemiology and Health Evaluation, Ben-Gurion University of the Negev Faculty of Health Sciences, Beer Sheva, Israel
  1. Correspondence to M.Sc. Chloe Pinto, chloe.pinto{at}


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.

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

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors CP, planned, conducted, reported and acquired the information for this case report. ZHP contributed to the writing of the paper and revised the draft paper.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.