Reviewer’s report
Title: 
Knowledge on cervical cancer and perceived barriers to the uptake of
HPV vaccination among health professionals.
Version: 
0 
Date: 
13 Jun 2020
Reviewer's report:
Thank you for the opportunity to read this manuscript. This is an important topic,
however I am sorry to say that I do not believe this work to be publishable. The
background needs more detail to situate the reader in the India context, the
descriptive stats need updating to reflect uptake among eligible participants for
screening and vaccination, not all participants, but most of all the questions are
not well designed and I am unclear why this population was selected to survey.
General
The language is not always as clear or grammatical as it might be and material is
repeated. If possible, it would be helpful for someone to proof read this prior to
any resubmission.
A few examples (illustrative not exhaustive) are below:
P3. Thus, effective screening reduces cervical cancer can be easily prevented
with regular screening programmes. 
This sentence currently makes no sense, suggest rewriting as "Thus, cervical
cancer can be easily prevented with regular screening programmes."
P4. This sentence is repeated in the same paragraph: "Vaccine was approved for
administration to boys between the ages of 9 and 26 years in developed
countries." With slight variation in wording and references.
P5. Knowledge of or about, not on.
Title
By the end of the title and abstract I was unclear if the health care professionals
(HCPs) were being surveyed about their own screening and vaccination
engagement or their delivery of vaccination to other people - the title is
ambiguous.
Abstract
This needs some tidying up - there is repetition of information and it is not
clearly worded in places, examples are below:
In the background, why is this a useful population to study? HCPs presumably
already know more about this than population. Why would this be helpful in
designing anything other than rather tailored education programmes?
A semi-structured questionnaire with 31 items - how many additional items were
asked? Do you mean semi-structured questionnaire or cross-sectional?
Were the HCPs related to gynaecology or primary care?
Abstract Results: 29.2% had done screening (performed a screening test/had
been screened?) and 19.8% got vaccinated. Are you talking about ppts as
patients or HCPs conducting procedures?
You repeat that 29.2% had done screening/got PAP test and that 19.8% got
vaccinated, only provide this information once.
Introduction
Introduce abbreviations such as VIA.
The introduction is too short and doesn't address why HCPs are the population of
interest here. Why are they representative of the wider population? If they aren't,
why are they a special population that needs exploring? What other studies have
been conducted in India around knowledge? What are the levels of uptake in
India? How long has the vaccine been available in India? 
Method
Under Measures - does number of youngsters mean number of children?
Yes/No/I don't know is not a Likert scale.
How is this a semi-structured questionnaire? What were the additional questions
asked that are not specified?
Results
The opening paragraph which is replicated in the abstract contains repetition of
information that I won't repeat here.
48 participants indicated not applicable to the question 'did you ever have a PAP
test', yet 22.3% (N=71) are male. While it is certainly possible for trans-men to
be in this survey, it seems unlikely that there are 23 of them, so the responses to
this question are not reliable.
The question 'willingness to receive HPV vaccine and recommendation" seems
to be merging two questions as does "Have you or yours family members
vaccinated for HPV". So you don't know how many of your participants were
themselves vaccinated if this is indeed just one question asking about themselves
and their family members.
Why is 30 the cut off comparison age?
You state that only 29.2% of your ppts had had screening and 19.8% had been
vaccinated. However, 29.2% of your total sample equals 93 ppts which is the
number of your Yes responses. You have not removed the number of screening
ineligible participants (ie the males). Likewise for vaccination, given the 26yr
age cutoff for eligibility, not all of your ppts would be eligible for vaccination so
this number does not reflect how many eligible people were vaccinated,
including ineligible people makes the data meaningless.
Discussion
The discussion includes some unqualified statements, e.g. "This shows that we
lack an organized opportunistic screening program for cervical cancer in India."
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the
authors.
No
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional statistical review is recommended, please specify what aspects
require further assessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
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