Title: Assessment of breast cancer risk perception, knowledge, and breast self-examination
practices among market women in Owo, Ondo state, Nigeria
Version: 3 Date: 13 Sep 2023
Reviewer:  Edmund Ndudi Ossai
Reviewer's report:
Review comments
General comments
I commend the Authors for the great efforts in reviewing the manuscript. I am also of the opinion
that there are still many aspects of the manuscripts that need to be revised. These include the
sampling and data analysis especially.
Authors should take note of the following comments.
Title
Change practice to practices
Abstract
Methods
Use p<0.05 for the determination of statistical significance
Results
Give an insight how the outcome variable(s) were determined.
Include Ondo state as a key word
Background
I commend the great improvement in the Background section of the manuscript. I also wish to
point out that the data used for most of the submissions are relatively old, (2012-2018). I suggest
that the Authors should replace the dates with very recent information.
Sample size determination
A total of 335 respondents were included in the study.
Sampling technique
Refer to Abstract section where it was stated that purposive sampling was used in the selection
of the study participants.
Stage 1
Include the sampling frame in the selection made in stage 1. Include the number of markets in
Owo town.
Stage 2
The market itself should be the one to be divided into clusters and not the women. The women
will belong to the clusters based on the location of their respective shops or any other criteria
used in determining the clusters.
Authors should state the basis for determining the clusters in this study. How many clusters were
identified and how many were selected using a simple random sampling technique of sampling.
Stage 3
This should be deleted. The basis of using cluster sampling is that all individuals that meet the
inclusion criteria (inside the selected clusters) will be included in the study. The selection should
stop at the 2nd stage.
Inclusion and Exclusion criteria should come under study population.
Also, one should be included first before the same person could be excluded. In this regard, the
buyers in the selected markets cannot be excluded.
Instrument of data collection
Is the questionnaire a validated one?
Who designed the questionnaire?
Was the questionnaire pre-tested before the commencement of data collection?
The responses to the questions above will help define the study instrument.
Method  of data collection
Authors should reconcile these two statements.
‘The questionnaire was administered by an interviewer.’
‘The participants were properly guided on how to complete the questionnaire and returned it
immediately after completion.’
Data analysis
Write SPSS in full. Also use IBM SPSS.
Use p value <0.05 to determine statistical significance.
Classification of the outcome variable
I will prefer a review of the classification of the outcome variable. This is because after
determining the mean score and for a normally distributed data (which I suppose will apply to the
results of this study) half of the respondents will have above and below the mean score. Based on
this observation applying what the Authors have in mind will be a faulty approach. I expect the
Authors to designate respondents who correctly answered 50% or more of the questions based
on the score as outlined as having good knowledge (or any other appropriate percent). Because
I expect the Authors to use binary logistic regression analysis those that scored <50% should
be regarded as having poor knowledge.
Authors should endeavour to apply binary logistic regression analysis in this study. Authors
should also include all the other outcome variables as independent variables while determining
the predictors of good practice of BSE.
Authors should attempt to report the results of the Chi square analysis using three categories to
understand while dichotomizing the outcome variables should be better.
The new title of Table 6 is applauded.
I advise the Authors to seek the services of a Statistician.
When these suggestions are applied, the Abstract and the Discussion sections will become better.