Reviewer’s report
Title: 
Cervical cancer in women under 30 years of age in Norway; a population-
based cohort study
Version: 
0 
Date: 
01 Jul 2020
Reviewer: 
Alejandra Castanon
Reviewer's report:
Dear Editor,
I appreciate the opportunity to review the manuscript titled "Cervical cancer in
women below age 30 years of age in Norway". The manuscript compares rates
and mortality from cervical cancer in women <30y to those diagnosed aged 30 or
older over a number of years. The manuscript adds to the existing literature and
is well written.
I have a few minor comments
Abstract
1.- The sentence in the methods "of 21,160 women with cervical cancer ..." I
think this is a result and should be moved to that section
2.- Please add that the HR were estimated over a 15years period to the methods
3.- Results - the quoted 0.76 HR for mortality is for women>30y. I think the
number should be 0.44?
Results
1.- I was surprised to see that 40% of women aged 20-25 has a previous negative
screening history and a further 21% abnormal tests. Authors mention that
screening is reminder based (hence women have to atrtenda t least once) from
age 25y. In the discussion they suggest that women attending for contraception
<25y could be offered screening (opportunistically). If this is the case does it
mean that a woman with one test age 21 is invited agains at age 24y? Please
clarify this in the discussion.
Discussion
In the first paragraph on page 10 the authors state that there was a slighter higher
proportion of women <30y with adenocarcinoma and adenosquam, but the
cancers did not tend to be more advanced. The authors do not show or mention
in the results a cross tabulation of histology by stage. This would be interesting
to add.
Line 27, page 9 - typo - Among 24-25 year olds - I think it should read 20-25y.
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