Reviewer’s report
Title: 
Barriers and facilitators for cervical cancer screening among young
people: a systematic review
Version: 
0 
Date: 
07 Dec 2020
Reviewer's report:
The topic of this manuscript submitted within the field of interest of the Journal,
but there are still some issues that should be amend.
1. The manuscript needs English revision. There are many grammatical issues.
Please read carefully manuscript again and correct the errors.For example, in
Line 218, you could write "Male physicians", instead of "Male gender of
physicians"or in page 4, Line 142, replace the phrases "remained broad" with
other appropriate phrases.
2. According to suggested revisions in sections (background, methods, result and
discussion), please change the Abstract.
3. According to PRISMA checklist, authors should write the eligibility criteria,
systematic review registration number, and the time interval that you searched.
Background:
1. The incidence and mortality rates that mentioned in Page 4, line 112,113: "…
with over 500,000 new cases and 250,000 deaths annually" are outdated and it
Can be Used the latest statistics from the World Health Organization and the
World Cancer Observatory.
2. Page 4, Line 122 outlines the benefits of cervical cancer screening. Butit did
not explain what the effectiveness and benefits of timely cervical cancer
screening. In a paragraph, Please explain the positive consequences of timely
cervical cancer screening.
3. In background, please explain the conditions of thecervical cancer screening
techniqueUsing the WHO or CDC guidelines (such as the target group for
cervical cancer screening, etc.).
METHODS
1. This section of the manuscript is very vague and poor. Please bolster this
section.
For coherence and easy understanding of the methods section, based on the
format of the latest systematic review articles that published in this journal,it is
suggested that the subtitles of the methods should be reported asfollows:
* Search strategy and Selection criteria
* Data extraction and quality assessment
* Analysis
2. Page 4, Line 142,143:
Please explain the Eligibility criteria of report characteristics (e.g., language,…)
that used as criteria for eligibility.
3. Page 4, Line 145: please correct the sentence of" The age cut-off of 35 years
was determined..." because the language used here is not good to understand.
4. Methods: The authors noted that one of Eligibility Criteria was related to
Population: "Young women (defined as 35 years of age or under) of any country
worldwide".Please explain why age is consideredless than 35 years old.
However, the World Health Organization have special emphasis on the
importance of cervical cancer screening in women aged 30-60.
5. Page 4, line 148: The authors noted, "We only examined original, peer-
reviewed literature." Please explain more, which studies do you mean as a peer-
reviewed literature?
6. Page 4, line 148, 149: Please notify to readers the purpose of "From inception"
in sentence "Databases were examined from inception until the date of our
literature searches (12/03/2020)". Please note the date, clearly.
7. Page 4, search strategy section: Can the authors provide greater information on
how they were search from database? For example, what was the range of
searchtime from database? Was search from database incused a combination of
MeSH, keywords and text words?
8. Page 4, line 158: data extraction: please provide more information related to
sentence of "Outcomes were summarized descriptively" and please explain the
processes for obtaining and confirming data from investigators.
9. Page 4, Does the quality assessment of the report checked? Please completely
explain it.
10. Page 4, analysis: if donemethods of analysis please describe it.
Result: 
1. Line 164: According to the format of the latest systematic review article
published in this journal, the phrase of "Search Yield" is better to delete.
2. Percent reports should be refine (E.g. use (22.2%) 8 instead of Africa (8/36,
22.2%).
3. In this study, the classification of barriers and facilitators is not well done.
Overally, barriers are divided into 3 main subtitles which can be said, these 3
subtitles are related to the individual level.Also, and there are a number of
problems in subdivisions. for example on page 5, lines 204 and 205, the phrase
"lack of physician recommendation" which is related to the provider is placed
under the subtitle "Lack of Knowledge / Awareness", or for example In line 245-
250 about the facilitators, almost all the items that the authors noted them are for
individual levels. Meanwhile the facilitators are not classified.
4. It is suggested to solve these problems and ambiguities and better understand
the results, classify using ecological approaches. For example, both barriers and
facilitators at all levels should be reported as follows or any classification related
to this comprehensive approach:
1) Intrapersonal or individual level, Interpersonal level, organizational level,
Community and policy level
2) Or individual, provider, health system, community
5. Page 6, line229: Replacethe sentence "….logistical barriers…" with other
appropriate sentence like "Barriers in organization or policy level". 
DISCUSSION
1. Please change this section based on suggested revisions in result section.
Strengths and Limitations
1. In strengths pointed that the authors considered 4 databases, while it is a
formal choice.
2. While the World Health Organization have special emphasis on the
importance of cervical cancer screening in women aged 30-60, authors can't
consider this item as strength.
CONCLUSION
1. Please change this section based on suggested revisions in result section.
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Declaration of competing interests
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
No
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
No
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes