Reviewer ’s report  
 
Title:  Factors associated with cervical cancer screening p articipation among immigrants of 
Russian, Somali and Kurdish origin: A population -based study in Finland  
 
Version: 0 Date: 27 Dec 2016 
 
Reviewer:  Manuel  Zorzi  
 
Reviewer’s report:  
 
I read with interest the paper by Idehen et al. The Authors interviewed 620 immigrant women of 
Russian, Kurdish and Somali origin in order t o highlight the factors associated with compliance 
with cervical cancer screening. They found both common and different factors among different 
ethic groups. In general, a lower uptake of screening was observed among women who refrain 
from using reproducti ve health services, those unemployed, less educated or with lower language 
proficiency.  
 
I have few comments for the authors.  
 
The participation rate for the study protocol among eligible women is cause of concern. In 
particular, because of selection bias the study population could not be representative of the whole 
population of immigrants. This would limit the generalisability of the study results and its 
conclusions. One possible analysis to examine this risk is to compare compliance with invitation 
to cervical screening among women who participated and did not participate to the study.  
 
The number of years immigrant women had been living in Finland has been categorised into two 
categories, i.e. more or less than ten years. In my opinion that interval has  a scarce discriminating 
power, because women are likely to experiment more difficulties in the first years after entry in a 
new Country. Please explain why you choose that categories and consider carrying out a 
sensitivity analysis using different categor ies (i.e., 3 or 5 years).  
 
Table 1: the variable 'pap test taken in the past five years' is not a socio -demographic 
characteristic and should be moved under the 'health care services category'.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to 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 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:  
 
Acceptable  
 
Declaration of competing interests  
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?  
 
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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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