RT Journal Article SR Electronic T1 A 15-year-old Nepali boy with metastasised colorectal cancer JF BMJ Case Reports FD BMJ Publishing Group Ltd SP bcr-2017-219289 DO 10.1136/bcr-2017-219289 VO 2017 A1 Chloe Pinto A1 Zvi Howard Perry YR 2017 UL http://casereports.bmj.com/content/2017/bcr-2017-219289.abstract AB 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.