Review for 10.1186/s12876-024-03477-4 (2024)

Title: Effect of Diabetes Mellitus Type 2 and Sulfonylurea on Colorectal Cancer Development:
A Case-Control Study
Version: 3 Date: 22 Aug 2024
Reviewer's report:
Dear authors:
I thank you to answer to my comments. You have done a very interesting work, however,
unfortunately, I am not able to accept it due to many problems that I have seen in your manuscript
I advise you to read the text of your manuscript carefully once and fix its writing problems. Also,
the text needs an advanced English edit.
Unfortunately, I did not find the answer to the following comments that I had expressed in the
previous review in your answer file
1-Despite the fact that in the title of your article you emphasize the role of Sulfonylurea
Consumption on colorectal cancer, you have not talked much about it. For example, it would
have been better if you had provided explanations about it in the introduction section, or
emphasized this issue more in the results section.
2-The nature of your article is case-control and the results of logistic regression analysis show
the odds ratio, but you have expressed all your interpretations based on incidence and risk.
3-It seems that the text of the article is not well adjusted in line with the purpose
4-abstract Not well written
5-The text of the article needs native editing
Introduction:
1- The last lines of the last paragraph are not related to the introduction and should be transferred
to the method. “This study will involve 800 cases of colorectal cancer and 800 controls adjusted
for age, sex, and other relevant factors.”
2- The last few sentences of the introduction should be transferred to the conclusion.
3- Please provide explanations regarding Sulfonylurea Consumption on in the introduction
section.” This results may guide future research into the mechanisms underlying the observed
associations and the development of tailored screening and prevention strategies for individuals
with these risk factors.”
Here, I will make some other points Introduction:
1- In the last paragraph of the introduction, the word risk should be removed and changed to
chance.
2- 2- There is no need to write the last three lines of the introduction. These sentences are suitable
for the method part.
Method:
1- I don't understand why the authors have made reference to the following sentences. The design
of the study and the writing of the report have been done based on the STROBE case-control
reporting guidelines (23). It was ensured that all researchers adhered to the World Medical
Association Declaration of Helsinki 2013 ethical protocols at all stages (24).
2- What do you mean by the following sentence? And why did you refer to this sentence?
Variables that were selected as confounding variables and adjusted in statistical analyzes are
considered protective factors (such as aspirin) or risk factors (such as smoking) of CRC based
on recent studies (3).
3- It is better to state in the statistical analysis section that qualitative variables are described
with numbers and percentages.
4-   Whitney U test???? be corrected
5- non-normally distributed???
6-   I recommend that you explain the statistical analysis as follows: To identify factors affecting
colorectal cancer, first, univariate logistic regression analysis was performed, and then, to control
confounders, variables with p value less than 0.2 in univariate regression were entered into
multivariate regression analysis. (Of course, you can write in this way if your criterion for
selecting multivariable regression variables is to have p value less than 0.2).
7-   What test was used to check the normality of quantitative variables?
8- Still, some numbers are not in English in the tables (of course, it may be like this in my system,
otherwise, please correct it).
9-   When you have stated the age below 45 years in the exclusion criteria, then it is better to
mention at the beginning of the method section which age group are the people under your study.
10-  10- It is better to define the dependent variable precisely
Results:
1- Pay attention to the following sentences in heading 3.1 The results of the chi-square test
showed that the case and the control populations were similar in aspirin consumption (p-value =
0.057), insulin consumption (p-value = 0.232), and T2D (p-value = 0.700), but cases were older
(p-value < 0.001), were more constituted by males (p-value < 0.001), had more smokers (p-value
= 0.016), had more cases, metformin consumers and sulfonylurea consumers (respectfully, p-
value = 0.012, p-value = 0.020 and p-value = 0.001). What does "had more cases" mean????
2- Heading title 3.2 should be duration of the diabetes because you have talked about this.
3-   In the manuscript  text, some words are written in bold letters, please correct them.
4-  In heading 3.1, you have written the p value related to diabetes 0.07, while according to the
table, this p value is related to the duration of the diabetes period.
5- The titles of the tables should be written at the top of the tables.
6- There is no need for form number 2. Its results are listed in the table