Reviewer’s report
Title: 
Sociodemographic correlates of colorectal cancer screening completion
among women adherent to mammography screening guidelines by place of birth
Version: 
0 
Date: 
08 Feb 2022
Reviewer's report:
BMWH-D-21-00456
Sociodemographic correlates of colorectal cancer screening completion among
women adherent to mammography screening guidelines Deeonna E Farr; Leslie
E Cofie; Alison T Brenner; Ronny A Bell; Daniel S Reuland BMC Women's
Health
Overall, an interesting study using data from the National Health Interview
Survey to examing why CRC screening falls short of breast screening uptake.
Abstract:
Typo, 'specific group underserved groups'
Introduction
Study aims/research questions at the end of the introduction would help guide
the reader. This would help clarify the focus on CRC screening uptake in relation
to breast screening uptake and any differential uptake between US born and
foreign-born women and other key sociodemographic factors. 
From the title of
the manuscript it suggests the focus is on a range of sociodemographic factors
but the results section focuses more on the US born and foreign born
comparison, clarifying the aims/title and focus of the results would help with
coherence. 
Methods
Page 6, line 12, clarify this sentence "The 2015 NHIS was used for this analysis
as it 13 contains a complete cancer control supplemental module which variables
needed to determine 14 respondents' CRC risk."
Page 7, line 4 "Due to the impact Medicare coverage has on screening outcomes,
two age groups were created for analysis: 50-64 years old 6 and 65 years or
older." Can you clarify what the impact is?
Page 7 - include how breast cancer risk and CRC risk were assessed - as reported
at the bottom of Table 1 and Table 2. My understanding these were beliefs that
were assessed as opposed to object risk as described on page 6.
Results: 
I found the results a little hard to follow. Table 1 is referred to but not explained
within the text. I was uncertain of what the columns on Place of Birth displayed -
is this adherence to breast cancer or adherence to CRC? Some clarification on
this would be helpful to guide the reader in interpreting the data. Also, on the
text in page 7 lines 21 and 22, these figures do not seem to be displayed in Table
1? Similarly, p 7 line 23 'US-born women reported higher screeing adherence
than their foreign-born counterparts (58% vs. 46%)' this doesn't appear to be in
the table and is it CRC screening? I found Table 2 easier to follow. 
Discussion:
The following articles provide relevant international literature to consider in
relation to understanding patterns of screening behaviour. In the UK all cancer
screening is free at the point of delivery through a National Health Service
permitting screening behaviour to be studied independently of the financing
issue:
McCowan C, McSkimming P, Papworth R, Kotzur M, McConnachie A,
Macdonald S, Wyke S, Crighton E, Campbell C, Weller D, Steele RJ.
Comparing uptake across breast, cervical and bowel screening at an individual
level: a retrospective cohort study. British journal of cancer. 2019
Oct;121(8):710-4.
Kotzur M, McCowan C, Macdonald S, Wyke S, Gatting L, Campbell C, Weller
D, Crighton E, Steele RJ, Robb KA. Why colorectal screening fails to achieve
the uptake rates of breast and cervical cancer screening: a comparative
qualitative study. BMJ Quality & Safety. 2020 Jun 1;29(6):482-90.
Lo SH, Waller J, Wardle J, von Wagner C. Comparing barriers to colorectal
cancer screening with barriers to breast and cervical screening: a population-
based survey of screening-age women in Great Britain. Journal of medical
screening. 2013 Jun;20(2):73-9.
Page 9, line 7, provide a reference for the previous research mentioned, "Despite
previous research suggesting perceived cancer risk as a correlate of screening
adherence"
Page 9, line 9, "While perceived risk is the behavioral construct with the most
consistent relationship to CRC test 10 completion" Is the evidence for this
statement as in reference 36? Make this more explicit or provide the relevant
reference.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
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Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
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