Reviewer’s report
Title: 
Comparison of cervical cancer screening by self-sampling papillomavirus
test versus pap-smear in underprivileged women in France
Version: 
2 
Date: 
16 Jul 2020
Reviewer's report:
COMMENTS BY REVIEWER, DR OKORO CHUKWUEMEKA C
Page 2: Title: Why should the study be considered an interventional study. What
intervention was done?
Page 5: BACKGROUND: provide a reference for the first statement in the
background (Human papillomavirus (HPV) is the most common sexually
transmitted infection.)
Page 5, LINE 26: "early stage uterine cancer". Which cancer are you referring to
as uterine cancer? Endometrial, cervical, liemyosarcoma?
Page 7, line 57. What does fluid milieu refer to? Liquid based cytology or
alcohol for slide preservation or what?
Page 8, line 19-26: in the practical sense, the cytological abnormalities detection
rates in the CG is among an unscreened population while the cytological
abnormalities detection rates in the EG is among those who are HPV positive.
Even before the study, it is expected that the rates will be higher in the EG.
Page 8, line 21: "ASC-US related to an HPV infection in the CG" .Was HPV
testing done for those in CG? How do you ascertain that the ASC-US is related
to HPV infection?
Page 9, line 33: ASC-US (3 of which were caused by an HPV infection) should
read ASC-US (3 of which were associated with HPV infection). There was no
demonstration of causality. Again, was HPV testing done for those in CG?
Page 9, line 41: What is the justification for not doing pap smear on the 3
patients whose sample were missing? What if they have premalignant lesions? Is
it ethically right considering the fact that they presented for CCS? 
Page 9, line 43: Sentences should be started with words rather than figures. 
Page 9, line 43-45: "Out of the 136 women who tested positive for HPV or
whose test could not be interpreted, 47 (34.6%) had a PS." This is worrisome.
Were they not counseled appropriately or was there any reason to explain this?
Experimental deign: Randomisation of months could influence the outcome of
the study. It is possible that certain participants could give consent or withhold
consent based on the particular group (CG or EG) being recruited in a particular
month. 
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