Review for 10.1186/s12876-024-03292-x (2024)

Title: PREDICTIVE VALUES OF AN IMMUNOLOGICAL FECAL OCCULT BLOOD
TEST FOR THE DIAGNOSIS OF COLORECTAL CANCER COMPARED USING
COLONOSCOPY IN SYMPTOMATIC PATIENTS IN YAOUNDE (CAMEROON)
Version: 5 Date: 25 Jan 2024
Reviewer:  Henry Dilonga Meriki
Reviewer's report:
Title: Predictive values of an immunological faecal occult blood test for the diagnosis of
colorectal cancer at the colonoscopy in Yaoundé (Cameroon)
Summary
The authors investigate the diagnostic performance of an immunological faecal occult blood
(iFOB) test in diagnosing colorectal cancer (CRC) in a setting with limited diagnostic resources
and emphasize the iFOB test's effectiveness in excluding patients who do not require a
colonoscopy. The study addresses a crucial health concern, particularly relevant in sub-Saharan
Africa, where screening practices may be limited.
Abstract
• Rephrase the following statement for clarity: "But its interest in SSA is few studied. "
Introduction
• I suggest authors replace "Europa" with "developed countries". I presume they are referring to
Europe and entire "developed countries". This correction should be made across the manuscript.
• In the following statement, "There is a lack of screening politics", I presumed they meant
policies or guidelines.
• There are better examples of socioeconomic development than the example of “flush toilet”
in the statement
"The socioeconomic development (such as health insurance, flush toilet)," I suggest that authors
rephrase the last three sentences before the objective for correctness and clarity.
Methods
• City and country instrument manufacturers should be mentioned
• Colonoscopy data included the preparation quality, the lesions' type and size, and the biopsy
realization, but not all was presented.
• The authors mentioned statistical comparisons were realized with the Chi-square test and
Fischer's exact test, but nowhere in the manuscript were some of these presented.
• I suggest including likelihood ratio, LR and area under the curve, and AUC with the graph in
the performance variables.
Results
• The patient enrollment flow chart (consort chart) will be more informative and may be included
in the manuscript.
Discussion
• The discussion ideas should be in separate paragraphs instead of headings
• This should be mentioned in the Results with a consort chart to show the enrollment flow chart
• In the statement below, the association data was not presented anywhere in the manuscript.
However, the authors mention that statistical comparisons were realized with the Chi-square
and Fischer's exact tests.
"This study found a significant association between alternating diarrhoea/constipation and
occult."
• Rephrase the following statement for clarity
"For this reason, any patient who is able to run realize the colonoscopy should benefit from this
exploration if there is possible. "
• In the following statement, I suggest replacing "settings" with "area."
• "Thus, in area where access to digestive endoscopy"
• Use study limitation instead of "limit of study"
• Consider revising the statement regarding the study's added value in the following statement
below., because the study by Knapp et al. (https://doi.org/10.1371/journal.pone.0243587 ) is still
a non-invasive screening evaluation with a similar objective, whether it is FIT or iFOB
"Our study is one of the first ones evaluating the diagnosis performance of an iFOB test regarding
the colonoscopy in an SSA."