Reviewer ’s report  
 
Title: Quality of Life of Breast and Cervical Cancer Survivors  
 
Version: 0 Date: 02 Sep 2016  
 
Reviewer: Julian Wienert  
 
Reviewer's report:  
 
Dear editor, dear authors,  
 
I was invited to assess and review the manuscript entitled "Quality of Life of Breast and Cervical 
Cancer Survivors and Their Return to the Workplace" which has been submitted to B MC 
Women's Health. The study provides valuable insights into the quality of life and return to work 
as well as potential determinants of both with a cross -sectional, observational/non -interventional 
study design. Though the manuscript and the results might  be of potential interest to the 
readership, there are several major and minor issues I have found and which should be addressed 
before considering publication.  
 
Abstract:  
- Please provide means and standard deviations for age and diagnosis.  
- Please cha nge back to work to return to the workplace to be in line with the wording you use 
throughout the manuscript.  
 
Background:  
page 4  
- 'if early detected'  
- Please provide examples of influential factors faced by female cancer survivors  
- Please abbreviate  quality of life the first time you use it and not on page 5.  
page 5  
- Please change the order here to be in line with the structure of your manuscript: breast 
cancer followed by cervical cancer  
- I am a little bit puzzled about the argument in the last paragraph: Is return to work generally 
favorable or not? are there mixed results? Please clarify this!  
- What about the interplay of QOL and RTW? A connection between both in your background 
section would clearly benefit the manuscript.  
page 6  
- Please s tate your hypotheses or at least your research questions to justify the variables you 
would like to assess and test as potential determinants of QOL and return to work.  
  
Method:  
page 6  
- Please name Authors according to citation stay before [16]. Please also provide a rational 
why you refer to a study with different cancer localizations as survival can differ 
tremendously.  
page 7  
- Please provide more detailed information on the calculated sample size needed for your 
analyses. How many cases were needed? Was the target met? What about the power and 
effect size?  
page 9  
- Please provide a rational why you designed a new questionnai re and on which basis this 
questionnaire is developed.  
page 10  
- Please provide an argument why the self -designed questionnaire was not suitable for 
reliability analyses. The reader does not know your questionnaire.  
page11  
- Are there any information on job type? If so, please provide!  
- t-test 
- Please provide the overall multivariate effect before assessing one -way analysis of variance.  
- Why is the use of logistic regression models not explained here?  
- Please provide the adequate test statistic fo r each characteristic.  
- How and why was the cluster effect entered as a repeated measurement effect? Does this 
make sense? I recently also read a study protocol on BMC Cancer about a return to work 
intervention using a multi center design where clinics w ere just entered as a fixed effect.  
 
Results:  
- Please provide information where the tables should be located  
page 12  
- Table 1  
page 13  
- Table 1  
page 14  
- Blue comma from track changes mode  
- Table 2  
- How does switching the job effects return to wo rk? Why is it brought up here, but not part of 
Table 3 and the discussion? Why is there a higher proportion of job switching/adjustment in 
females with breast cancer?  
- Please provide reference scores for your EORTC values. This will help the reader to pu t 
your results in relation to a broader population and if the QOL of your sample is higher or 
lower.  
page 15  
- Please provide confidence intervals for all analyses when reporting results in the text to 
assess the scope of the effect in addition to your ta bles. 
- Please be more specific when reporting QOL dimensions of overall QOL. When you results 
on Global health status, please name it Global health status instead of QOL to avoid 
confusion.  
 
 
Discussion:  
page 17  
- Please organize your discussion according to the order of your results --> do not report 
results on returning to the workplace first.  
page 18  
- Please discuss your contradictory results! Are there any ideas why your results point into a 
different direc tion?  
page 19  
- Please add [28] after Hsu et al.  
 
Conclusion:  
page 23  
- Please do not use too colloquial language. To assess the level of QOL in your sample, 
reference values would be helpful! Lower functioning compared to which group?  
- Please provide the percentages for both cancer types and return to work. I think that 'about a 
half' would not be adequate enough.  
- Please add the percentage of switched/adjusted job roles  
After assessing the manuscript I recommend a major revision if the authors wis h to resubmit 
their manuscript to BMC Women's Health. I wish the authors all the best for their future work 
and research and hope that my comments help them with their manuscript.  
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.  
 
Unable to assess  
 
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 st atistics 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, funding, 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  
manuscri pt? 
 
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, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I h ave no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wis h to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal