Reviewer ’s report  
 
Title: Factors associated with cervical cancer screening among young unmarried Japanese women:  
results from an internet -based survey  
 
Version: 0 Date: 20 Apr 2018  
 
Reviewer: Alejandra Castanon  
 
Reviewer's report:  
Dear Editor,  
Many thanks for the opportunity to review the manuscript titled "Factors that are correlated with 
cervical cancer screening among unmarried and sexually active Japanese women aged 20 -28 years: 
results from an internet -based survey" by Noriyo Kaneko.  
This is an interesting manuscript using an internet survey to explore factors correlated with 
screening in young Japanese women. This is an important area of research  because vaccination 
rates in japan have fallen so dramatically and the risk of acquiring an HPV infection has increased 
and is increasing among young women. The manuscript would benefit from extensive editing to 
improve the language.  
Please find my comme nts below.  
Major comments  
Background - please expand on how screening is offered in Japan. The authors indicate that 
pregnant women are offered it. What about those that attend for contraception or for other health 
complaints to the doctor? How is offered the government coupons? Please expand.  
Please provide a reference to the study assessing the effectiveness of the coupon (line 84 - 
background).  
Line 86 - background - please add 'perceived' susceptibility. Please ensure that the word perceived 
always acc ompanies susceptibility throughout the document as it becomes confusing on occasion.  
Methods/discussion - One major limitation is not knowing how the profile of the 700 participants 
in the study compared to the wider population. However, they state that th e company can specify 
sociodemographic groups from the registered population. So, could the authors compare the 
sociodemographic distribution of all women registered with the company to the 700 included in 
the study? Do most young women have access to the internet? Even in remote/rural areas? Did the 
marketing company have any information on the urban/rural distribution of women surveyed?  
It is my opinion that a more in -depth discussion on this issues is needed, not just an 
acknowledgment that it is a limit ation.  
Is the relationship between number of sexual partners and attendance to screening related to the 
fact that they are offered screening when they attend for contraception?  
What kind of promotional campaigns (that are not already being carried out) are the authors 
suggesting? Line 268  
 
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.  
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:  
Needs some language corrections before being published  
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, fund ing, 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, w rite '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  
I agree to the open peer review policy of the journal. I understand that my name will be include d 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
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I agree for my report to be made available under an Open A ccess Creative Commons CC -BY 
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not wish to be included in my named report can be included as confiden tial comments to the 
editors, which will not be published.  
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