Title: Cervical cancer screening: Comparative study of human papillomavirus detection
between cervical cytology and urine samples
Version: 0 Date: 29 Sep 2024
Reviewer:  Folkert J. van Kemenade
Reviewer's report:
BMC women’s health my comments
The manuscript describes experiments to add proof to the feasibility of using voided urine
sampling rather than vaginal sampling. This is a valid aim. Authors used the method of doing
both tests in one testpopulation. The essence of the screening tests is risk assessment and validity
is measured by their mutual ability to detect presence of HPV and HPV type. In addition, it
makes sense to set this off against a useful endpoint i.e. CIN2+ or CIN3+. This is what authors
tried to explain in the manuscript. However, I have some serious issues with its current form.
The introduction is too long and mostly irrelevant for the topic of the manuscript. Please leave
out all ‘nice to mention’  in favour of ‘have to mention’
The methods read like the lab instructions have been copied (eg “ after soaking the sample” and
“transfer the mixed fluids to a centrifuge tube” and many more). This is inappropriately detailed
and can be formulated much more briefly without losing the essence.
The result section is unreadeable as such. It seems that authors in their discussion, eg, for the
subtype results, have copied/pasted 17 sentence for each type. Please amend and summarize
while referring to the tables. Try to image a reader trying to read this text. Make sure text and
images are equally understandeably.
Figure legends and tables legends only represent a summary of what authors feel fit to conclude.
I think legend should described what is represented.
The discussion need thorough cleaning up. Authors should start with ‘our result show’, which
they actually do, but at the beginning of the second paragraph. The preceding paragraph can be
omitted at that place, taken up, shortened by summarizing and placing it deeper in the discussion.
I missed an enumeration of strong points and weaks points in the discussion.
Detailed comments of sentences can be considered as minor details. Yet, I observed so many
that I think authors should find a native speaker and have it rewritten. Use of present and past
tense was difficult to follow.
Some sentences that could be phrased in a more clear way:
eg
Although HPV screening and type diagnosis have significant effects [..].
Comment: what do writers mean with ‘type diagnosis’ and ‘effects’. Type diagnosis as to
diagnose i.e. to say that HPV may be helpful in diagnosing next to screening? With effects they
mean what?
eg
Supervisory or objective reasons?
Comment: what do writers mean with supervisory and objective reasons? I can guess or suppose
several things, but such terminology is too vague.
eg
Reduce disease prognosis?
Comment: one can increase likelihood of disease being present or measure increase risk in
screening. Alternatively, presence of HPV16 incurs a worse prognosis for eg CIN3 than for
instance HPV 52. I simply can’t figure out that authors mean.
eg
In addition urine can be self sampled […] …
Comment: Authors meant self collected ie without being invasive. The latter is the contrast with
vaginal sampling.
eg
time limitations, traditional thinking, etc.
Comment: avoid “etc”.
eg
With the clinical application of Internet nursing (?), home sampling of urine has become
the development trend of cervical cancer screening and detection, which effectively enhances
patients' participation in disease screening [9].
Comment: delete entire sentence.  .
eg
The patient is aged 20-60 years
Eg: patients were aged 20-60yrs.
There are relevant indications for colposcopy biopsy diagnosis.
Comment: it suffices to write that colposcopy directed biopsy was indicated.