Reviewer ’s report  
 
Title:  Massive single visit cervical pre -cancer and cancer screening in eastern Democratic 
Republic of Congo  
 
Version: 0 Date: 26 Sep 2018 
 
Reviewer:  Lin Zhu 
 
Reviewer’s report:  
 
This study examines a cervical cancer screening campaign in the Democratic Republic of Congo. 
It evaluates the screening intervention, and the findings gene rated important policy and research 
implications. Cancer screening interventions and studies in understudied and underprivileged 
countries like  this one is urgently needed.  
 
The authors could consider addressing the following issues to further improve th e quality of this 
paper.  
 
1. The authors provided a detailed description of the screening procedures, which is very 
important. However, it would also be interesting to have more details on the recruitment 
strategies. One of the challenges of cancer screeni ng campaigns or interventions is to recruit 
those in need, and as we know from previous studies, those who were most underprivileged are 
usually the hardest to recruit or reach. This could be addressed in the Methods section, and/or the 
Discussion section.  What kind of message was included? Was is culturally tailored? It's provide 
some implications for future studies.  
 
2. Related to the previous point, community -based participatory research has proven to be 
effective in promoting cancer screening in underpr ivileged populations, such as low -income, 
ethnic minorities in the US. Some example articles are included below. These studies were 
conducted in collaboration with faith -based organizations, similarly to this study under review. 
It'd be interesting to see how this approach could be explored to expand the efforts to promote 
screening and vaccination. The authors should consider discussing this point in this article.  
 
Ma GX, Lee M, Beeber M, Das R, Feng Z, Wang MQ, Tan Y, Zhu L, Navder K, Shireman TI, 
Siu P. C ommunity -Clinical Linkage Intervention to Improve Colorectal Cancer Screening 
Among Underserved Korean Americans. Cancer Health Disparities. 2018 Jan 1.  
 
Han, Hae -Ra, Youngshin Song, Miyong Kim, Haley K. Hedlin, Kyounghae Kim, Hochang Ben 
Lee, and Debra Roter. "Breast and cervical cancer screening literacy among Korean American 
women: a community health worker -led intervention." American journal of public h ealth 107, 
no. 1 (2017): 159 -165. 
 
Example articles: Fang, Carolyn Y., Grace X. Ma, Yin Tan, and Nungja Chi. "A multifaceted 
intervention to increase cervical cancer screening among underserved Korean women." Cancer 
Epidemiology and Prevention Biomarkers 16 , no. 6 (2007): 1298 -1302.      
3. The authors mentioned that there are strong need for HPV vaccination. Did the study actually 
measure the knowledge/awareness of HPV vaccination?  When the HPV vaccine is available in 
DRC, what would be some good strategi es to promote the vaccination? This might also be a 
good discussion point.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
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 statistics 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:  
 
Acceptable  
 
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 a n 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 
manuscript?  
 
4. Have you received reimb ursements, 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 have 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 wish to be includ ed 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