Reviewer ’s report  
 
Title: Towards equity in organised cancer screening: the case of cervical cancer screening in 
France  
 
Version: 0 Date: 22 May 2018  
 
Reviewer: Carolyn Y. Fang  
 
Reviewer's report:  
 
This manuscript, which was submitted for consideration as a Debate, presents the argument that 
a national cervica l cancer screening program (currently being developed and implemented in 
France) should be guided by an equity -oriented approach rather than an equality -based approach.  
Ethical aspects of an equity -oriented policy are discussed, and the manuscript does a good job of 
summarizing two key ethical issues raised by this approach, namely: (1) the risk of 
stigmatization among disadvantaged subgroups; and (2) how to maintain respect for individual 
autonomy while enhancing population health. Overall, this is a conc isely written manuscript that 
offers some interesting points for consideration.  Below are a few comments that could help to 
strengthen certain aspects of the manuscript.  
1. Although recommendations and targeted strategies for selected high -risk subgroup s are 
presented (both in the text and in Table 1), it is unclear how these strategies are novel or 
different from what is currently being done.  
 
2. In the Conclusion paragraph (page 9), it is indicated that "an overview of ethics and social 
sciences are a nd will be an integral part of the process" and that the "establishment of a 
proportionate universalism must take into account the psychosocial reasons for social 
inequalities in health and promote actions such as combating social isolation…".  It is 
stran ge to see these concepts (social sciences, psychosocial reasons for social inequalities, 
social isolation) raised for the first time in the Conclusion.  If these concepts play a primary 
role, then they should be introduced earlier in the manuscript, rather  than only peripherally 
mentioned at the end.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments t o the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
  
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
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 req uire further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing i nterests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are  you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you  have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any , please give details below.  
 
I declare that I have no competing interests.  
 
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on my report to the authors and, if the manuscript is accepted for publication, my named report  
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