Reviewer’s report
Title:  Socio-Demographic  Characteristics  and  Associated  Factors  Influencing  Cervical  Cancer
Screening among Women Attending in St. Paul ’s Teaching and Referral Hospital, Ethiopia
Version: 1 Date: 25 Jun 2019
Reviewer: Björn Strander
Reviewer's report:
Line 102  The power calculation should show the power of the study to answer the main research
question. As this is described as socioeconomic and related factors there should be a definition on what
difference between groups is clinical/practical meaningful to detect and how large sample is needed to
detect such difference, thus avoiding type 2-error. I still do not understand the power calculation and
the response does not shed light. Is 50% the assumed prevalence of screening? Then this should be
spelled out. But whay, and this is not stated as the main research question. I suggest editor check this
with a statistician.
I note that my suggestion on the aim of the study was not met. "The aim is stated as "the purpose of this
study is to determine the influence of socio-demographic characteristics and related factors on cervical
screening." I think the aim should be restricted to cover the geographical area. Or possibly "in an
African setting". The result cannot be valid for all populations. 
Author response: We have made revision on revised manuscript on page 4-5 line 89-91." /They have
not revised the aim/
L 46 Cervical cancer is the most important public health priority issue throughout the world. Is it?
Reference? 
Author response: Most previous studies describes; cervical cancer is the most devastating disease of
women particularly in developing countries. We have added reference on page 3 line 46 [3, 6]. /This
reference find cervical cancer prevention important but does not state what the authors claim it states. If
I am wrong, I would appreciate the exact quotation/
Table 3, 4 and 5 has been changed but would benefit from summing up columns to 100 % per cent
instead of rows. The reader is more interested in knowing how exposures are distributed for each
outcome than vice versa. I.e. Age at first sex < 18 . Unscreened:  No 274 (73% ) Yes 99 (27%)
Screened No 40 (77%) Yes 12 (23%). The same applies for table 4.
Table 4 should have an explanation of the odds ratios. It is in the manuscript text, but should be
included in the table as well. 
The role of the funding source should be described in the manuscript. To me it seems odd that the
funding source contributed in the data collection process (making interviews?). Important to know is if
the study is independent of the funding source or if the funding source has had influence on the
manuscript and publication. 
Limitations with the study should be described more fully. A major limitation with a hospital based
study is that it is unclear to what extent it is reflects the entire population. The use of Purposive
sampling increases the risk of bias and decreases reliability. There is no data or analysis of drop-outs.
Neither  a  flow  chart,  despite  STROBE-recommendation  (the  authors  have  considered  this
recommendation as "Not applicable" which is wrong), showing how many women who were excluded
and how many women were eligible for inclusion but were not included. Or if this is not known, it
should be clearly stated as a limitation.
I find the article acceptable for publication after these changes have been made
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.
Yes
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 recommend additional statistical review
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
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