Strengthening cancer care for the LGBTQIA+ population in Nepal: A narrative review to set priorities for equitable oncology services

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.