Shrestha Sunil, Pathak Nabin, Sapkota Simit, Thapa Sudip, Pandit Subhas, Bhandari Jeebana, Barman Pankaj, Khanal Pratik, Ranabhat Kamal, Paudyal Vibhu, Singh Deependra
Department of Research and Academics, Kathmandu Cancer Center, Nala Road, Tathali, Bhaktapur, Nepal.
Drug Information Unit and Pharmacovigilance Cell, Department of Pharmacy, Hetauda Hospital, Madan Bhandari Academy of Health Sciences, Hetauda, Bagmati Province, Nepal.
Dialogues Health. 2025 Jul 5;7:100229. doi: 10.1016/j.dialog.2025.100229. eCollection 2025 Dec.
Cancer epidemiology and care services in low- and middle-income countries, has traditionally overlooked the specific needs of the lesbian, gay, bisexual, transgender, queer, intersex, and asexual community, including people who identify with diverse gender identities and sexual orientations (LGBTQIA+). This narrative review examines the intersection of LGBTQIA+ individual's health and oncology cases in Nepal, highlighting disparities in cancer risk factors, delayed diagnosis, limited screening access and the compounding effects of social stigma and discrimination. Drawing from regional data and global insights, we identify systemic barriersincluding heteronormative healthcare environments, lack of provider training in LGBTQIA+-inclusive oncology, and policy gaps that hinder equitable cancer care access. We also outline targeted strategies to improve cancer outcomes for LGBTQIA+ individuals, including stakeholder engagement, culturally competent oncology training for healthcare providers and students, and community-led education and advocacy. This review underscores the urgent need to integrate LGBTQIA+-specific priorities into Nepal's national cancer strategies to advance equity in oncology care delivery.
低收入和中等收入国家的癌症流行病学与护理服务，传统上一直忽视了女同性恋、男同性恋、双性恋、跨性别、酷儿、双性人以及无性恋群体的特殊需求，包括认同不同性别身份和性取向的人群（LGBTQIA+）。这篇叙述性综述探讨了尼泊尔LGBTQIA+个体的健康与肿瘤病例的交叉点，强调了癌症风险因素、诊断延迟、筛查机会有限以及社会耻辱和歧视的复合影响方面的差异。借鉴区域数据和全球见解，我们确定了系统性障碍，包括异性恋规范的医疗环境、医疗服务提供者缺乏LGBTQIA+包容性肿瘤学培训以及阻碍公平获得癌症护理的政策差距。我们还概述了改善LGBTQIA+个体癌症治疗结果的针对性策略，包括利益相关者参与、为医疗服务提供者和学生提供具有文化胜任力的肿瘤学培训，以及社区主导的教育和宣传。这篇综述强调了迫切需要将LGBTQIA+特定优先事项纳入尼泊尔的国家癌症战略，以促进肿瘤护理服务的公平性。
