Background: The incidence of early‐onset colorectal cancer (EO‐CRC) has been consistently rising leading to a significant cancer burden among younger adults in Asian and Middle Eastern high‐income countries. The study aims to investigate the survival outcomes of EO‐CRC among high‐income Asian and Middle Eastern populations from 1990 to 2019 using the mortality‐to‐incidence ratio, with a focus on examining the differences in gender.Methods: This is a systematic analysis of the Global Burden of Disease (GBD) 2019 study. We include individuals aged 15 to 49 years old in high‐income Asian and the Middle Eastern countries. The colorectal cancer mortality‐to‐incidence ratio (MIR) was calculated for both genders by dividing the age‐specific mortality rate per 100,000 for colorectal cancer by the age‐specific incidence rate per 100,000 for each nation in the sample for a given year.Results: An overall decline in male and female MIR was observed from 1990 to 2019 in Asian and Middle Eastern countries. Ten out of thirteen Asian and Middle Eastern countries had a higher female MIR compared to their male counterparts. The global male MIR was found to be significantly higher than that of female (p‐value 0.008, coefficient estimate: 1.51). In Middle Eastern countries, Saudi Arabia had a significantly higher female MIR compared to their male counterparts (p < 0.0001, coefficient estimate: 12.65).Conclusion: This research addresses the knowledge gap concerning gender‐based differences in EO‐CRC survival outcomes in high‐income Asian and Middle Eastern countries, providing insights into the factors influencing these disparities in these regions. Policymakers should focus on developing targeted prevention and treatment programs for women, and addressing cultural and social barriers that may prevent women from seeking timely medical care.

Background: Colorectal cancer (CRC) is the most diagnosed cancer among males and third among females in Saudi Arabia, with up to two-third diagnosed at advanced stage. The objective of our study was to estimate CRC survival and determine prognostic factors. Methods: Ministry of National Guard- Health Affairs (MNG-HA) registry data was utilized to identify patients diagnosed with CRC between 2009 and 2017. Cases were followed until December 30th, 2017 to assess their one-, three-, and five-year CRC-specific survivals. Kaplan-Meier method and Cox proportional hazard models were used to assess survival from CRC. Results: A total of 1012 CRC patients were diagnosed during 2009–2017. Nearly, one-fourth of the patients presented with rectal tumor, 42.89% with left colon and 33.41% of the cases were diagnosed at distant metastasis stage. The overall one-, three-, and five-year survival were 83, 65 and 52.0%, respectively. The five-year survival was 79.85% for localized stage, 63.25% for regional stage and 20.31% for distant metastasis. Multivariate analyses showed that age, diagnosis period, stage, nationality, basis of diagnosis, morphology and location of tumor were associated with survival. Conclusions: Findings reveal poor survival compared to Surveillance, Epidemiology, and End Results (SEER) population. Diagnoses at late stage and no surgical and/or perioperative chemotherapy were associated with increased risk of death. Population-based screening in this population should be considered.

Early-onset colorectal cancer (EO-CRC) incidence and prevalence trends in the rise in high income countries, such as the Gulf Cooperation Council (GCC) countries. The study aimed to offer an up-to-date assessment of the overall burden of CRC, and EO-CRC in GCC countries and project its incidence and mortality in 2030. The prevalence, incidence, mortality, years of life lived with disability (YLDs), and disability-adjusted life years (DALYs) of CRC were obtained from the Global Burden of Disease (GBD) Study 2019. The incidence and mortality of CRC, and EO-CRC up to 2030 were predicted. All GCC countries showed a higher annual average percentage changes (AAPC) AAPC incidence rate for EO-CRC compared to CRC. In Saudi Arabia the number of CRC cases has increased from 1990 1484.57; (95 % UI 1987.98,1083.86) 11.4-fold-increase to 16991.83; (95 % UI 21754.79,12892.12) in 2019. In 2030, the total incidence cases of CRC for the six Gulf countries are expected to reach 13,339 thousand, primarily driven by Saudi Arabia with 7,910.19 cases. In 2030, the CRC mortality rate is projected to be 7,647 cases, with nearly 57 % of CRC mortality cases anticipated in Saudi Arabia. This study sheds light on the alarming rise in CRC and EO-CRC across Gulf countries from 1990 to 2019, emphasizing Saudi Arabia's significant burden. It projects a concerning increase in CRC incidence and mortality by 2030, primarily in Saudi Arabia, and highlights the need for immediate public health interventions.

• High BMI and low milk intake are major risk factors for early onset colorectal cancer in GCC countries. • High BMI identified as key risk factor for male EO-CRC in GCC countries. • Low milk intake highest risk factor for female, second highest for male EO-CRC in GCC countries. • Collaborative region-specific interventions are needed to reduce EO-CRC burden in GCC countries.

Objective: To we examine the temporal patterns of the burden of Alzheimer's disease and their association with Sociodemographic Index in countries with varying rates of aging.Method: Data were obtained from Global Burden of Diseases studies (GBD) 2019 and were used to compare countries with different rates of change in aging population from 1990 to 2019. We collected the data of the age‐standardized rates per 100,000 of disability‐adjusted life years (DALYs), incidence, prevalence of Alzheimer's disease and other dementias, and the age‐specific population rates per 100,000.Results: Countries with high rates of change in their aging populations had an increase in DALYs, incidence, and prevalence of Alzheimer's disease and other dementias over the last 30 years. Countries with a high rate of change in aging population had a significantly positive association among DALYs, incidence, and prevalence of Alzheimer's disease and other dementias. In contrast, countries with a medium and low rate of change in aging population had negative associations between DALYs and incidence of Alzheimer's disease and other dementias.Conclusion: This study highlights the significant impact of demographic changes on the burden, prevalence, and incidence of Alzheimer's disease and other dementia. The study also found that robust health care and social systems, as reflected by a higher Sociodemographic Index, can contribute to reducing the burden of Alzheimer's disease and other dementias in medium to low rates of aging populations. The findings underscore the importance of investing in health care and social systems to address the growing burden of these conditions, especially in countries with a high rate of change in the aging population.

Background: Sleep hygiene habits are essential to maintaining a healthy lifestyle. Sleep deprivation is a prevalent problem worldwide. Multiple studies have shown a high prevalence of sleep insufficiency among medical students due to high academic load, caffeine intake, and high-stress levels. Objectives: This study explores the relationship between sleep quality, academic performance, and psychological distress among medical students at Alfaisal University, Riyadh, Saudi Arabia. Methods: This cross-sectional study was conducted on medical students of all academic years at Alfaisal University, Riyadh. Two popular surveys – the Pittsburgh sleep quality index (PSQI) and K10 - were used to assess sleep quality and psychological distress, respectively. In addition, the survey contained questions on socio-demographics and academic performance. Sociodemographic characteristics were assessed across groups having poor and good sleep quality. In multivariate analysis, we employed conscious variable selection to develop models. All statistical tests were two-sided at P < 0.05 as statistically significant. Results: A total of 241 respondents participated in the study. Most respondents reported poor sleep quality (75.93%). The highest psychological distress was reported among respondents with poor sleep quality (48.63%). The relationship between Kessler's Psychological Distress score and sleep quality score was significantly positive and linear (P < 0.0001). The mean PSQI score was higher in students with lower GPAs (1.50 - 2.99) than in those with higher GPAs (3.00 - 4.00). This shows that those students who sleep well perform academically better. Conclusions: The quality of sleep among medical students is poor, which is associated with psychological distress and poor academic performance. It is highly suggested that the awareness of sleep hygiene with healthy sleep habits be campaigned among medical students. Also, academic mentors, program directors, and coordinators play a crucial role in ensuring that medical students are not academically overwhelmed.