Abstract
The burden of cancer is estimated to be increasing in Nepal, whilst the country lacks national established guidelines or protocols for referral of cancer cases. Cancer patients are presenting many different health facilities throughout the country. In rural areas almost all cancer patients have their first diagnosis when visiting a health assistant or nurse at their nearest primary health care delivery service. If cancer is suspected, health care assistants or nurses will refer the patient to a medical doctor at the primary health centre, or refer the patient directly to the cancer treatment centre or oncology department of the closest hospital. Patients from urban areas will usually be seen for the first time by a medical doctor initially and then referred to either the cancer treatment centre or oncology department of the hospital. Both in rural and urban areas the referral for treatment is determined by both the patients’ capacity to pay for treatment own healthcare, as well as their geographical location (i.e. availability and accessibility of cancer treatment services.
Highlights
Nepal is situated between two large countries - China and India
A national cancer registry programme has been initiated in Nepal in 2003, which is in turn based on-based cancer registries [6].This initiative includes information from the registries above plus the following: [4]
Based on data retrieved from Nepalese hospital-based-cancer registries from 2003 to 2012 the total number of new cancer cases reported in the hospital-based registries listed above was 55,931 [3]
Summary
Nepal is situated between two large countries - China and India. These neighbouring countries have information systems in place including population based cancer registries, which is not the case in Nepal [1]. As the number of new cancer cases increased [2,3,4,5,9], the government and private sector established new cancer hospitals in different parts of the country. The Ministry of Health in Nepal is providing US $ 620 to support each individual who is diagnosed with cancer This amount is directly transferred to the cancer institution in Nepal to cover the expenses of treatment such as surgery, radiotherapy, medications and diagnostic and follow up investigations [12]. Most patients receive treatment at the hospital which is nearest to their homes (Figure 1)
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