Barriers for resuming endoscopy service in the context of COVID-19 pandemic:A multicenter survey from Egypt

BACKGROUND The current coronavirus disease 2019(COVID-19)pandemic has affected routine endoscopy service across the gastroenterology community.This led to the suspension of service provision for elective cases.AIM To assess the potential barriers for resuming the endoscopy service in Egypt.METHODS A national online survey,four domains,was disseminated over a period of 4 wk in August 2020.The primary outcome of the survey was to determine the impact of the COVID-19 pandemic on the endoscopy service and barriers to the full resumption of a disabled center(s).RESULTS A hundred and thirteen Egyptian endoscopy centers participated in the survey.The waiting list was increased by≥50% in 44.9% of areas with clusters of COVID-19 cases(n=49)and in 35.5% of areas with sporadic cases(n=62).Thirty nine(34.8%)centers suffered from staff shortage,which was considered a barrier against service resumption by 86.4% of centers in per-protocol analysis.In multivariate analysis,the burden of cases in the unit locality,staff shortage/recovery and the availability of separate designated rooms for COVID-19 cases could markedly affect the resumption of endoscopy practice(P=0.029,<0.001 and 0.02,respectively)and Odd’s ratio(0.15,1.8 and 0.16,respectively).CONCLUSION The COVID-19 pandemic has led to restrictions in endoscopic volumes.The staff shortage/recovery and the availability of COVID-19 designed rooms are the most important barriers against recovery.Increasing working hours and dividing endoscopy staff into teams may help to overcome the current situation.

Colorectal cancer in Arab world:A systematic review

BACKGROUND The incidence of colorectal cancer(CRC)is increasing among young individuals in the Arab world as well as in other regions of the world.AIM To explore the incidence and prevalence of CRC in the Arab world.METHODS The PubMed,Scopus,Web of Science,EBSCO and Wiley databases were searched to retrieve relevant articles irrespective of the language or the publication year.The search terms were("colon OR rectum OR sigmoid OR rectal OR colonic OR colorectal")AND("cancer OR malignancy OR malignant OR neoplasm")AND("Jordan"OR"United Arab Emirates"OR"Bahrain"OR"Tunisia"OR"Algeria"OR"Djibouti"OR"Saudi Arabia"OR"Sudan"OR"Syria"OR"Somalia"OR"Iraq"OR"Oman"OR"Palestine"OR"Qatar"OR"Comoros"OR"Kuwait"OR"Lebanon"OR"Libya"OR"Egypt"OR"Morocco"OR"Mauritania"OR"Yemen").Reviews,metaanalyses,and articles containing nonoriginal data were excluded.Retrieved articles were screened,and relevant data were extracted.Descriptive statistics were used for data analysis.RESULTS Nine studies were included.Five of the studies provided information regarding the prevalence of CRC.The prevalence of CRC was 0.72% in Saudi Arabia and 0.78% in the United Arab Emirate,while in Egypt,it ranged from 0.4% to 14%.Four studies showed information regarding the incidence.The annual incidence rate of CRC in Qatar was 7.5/100000/year.In Egypt,the crude incidence rate(CIR)in males was 3.1 for colon cancer and 1 for rectal cancer,while in females,it was 2.3 for colon cancer and 0.8 for rectal cancer.The age-standardized rate for CRC incidence in 2003 was 36.90 for males,26.50 for females,and 30.49 for both sexes in Saudi Arabia.In 2016,the CIRs in Saudi Arabia were 3.6 and 2.1 in females for colon cancer and rectal cancer,respectively,while in males,it was 3.3 and 2.8 for colon cancer and rectal cancer,respectively.One study in Egypt revealed that 25% of CRC cases occurred among individuals younger than 40 years old.CONCLUSION There is a considerable prevalence of CRC in some Arab countries.More studies are needed to explore the incidence and prevalence of CRC in the rest of the Arab world.