Title: Self-screening Practice of Breast Cancer and Associated factors Among Female Students
in Ethiopian Universities using the Theory of Planned Behavior: A Cross sectional study
Version: 2 Date: 14 Jul 2024
Reviewer's report:
Thank you for the opportunity to review this manuscript. The paper covers an important topic;
however, some methodological flaws have been spotted, such as the unclarity of the inclusion
criteria and the fact that no sample size calculation was performed. Also, the paper has many
grammatical mistakes which need to be revised by a native speaker healthcare provider. Also,
a huge plagiarism was found in the manuscript (46%) which consider revising the manuscript
and paraphrasing.
Introduction:
Line 67: “Breast cancer is the top-ranked cancer among females” top ranked in what (prevalence,
incidence, mortality?), this sentence should be paraphrased in more academic form.
Line 67: “with 2.1 million new cases worldwide” this sentence reference is based on old
statistics; suggest adding statistics about breast cancer in 2024.
Line 75-76: “The 2016 American Association for Cancer Education (AACE) revealed that”
do the authors mean “The 2016 American Association for Cancer Education (AACE) report
revealed that”?
Methods:
Line 108: which university?
Line 111: why the authors did not included students who do not use social media? That would
affect the generalizability of the data.
Line 111: the inclusion criteria is not clear; did the authors included students with Ethiopian
nationality only or they included foreign students also? From which colleges? did they include
medical college students? that would give false positive of good knowledge since medical
college students already have good knowledge about breast cancer.
Line 118-119: why the authors did not calculate the sample size? That raises concerns about the
generalizability of the results.
Line 131: “(Table 3)” the authors were talking about the study tool, and they mentioned table 3
which presents logistic regression analysis; is this a spelling mistake?
Line 133: who is the “student's representative”? was there any one of the study team who was
responsible for the data collection process? Was there anyone monitoring the data collection
process to ensure the validity of this process?
Line 139: what was the results of Cronbach’s alpha test? How did the authors ensure the clarity
of the survey and how did they deal with respondents’ feedback about the survey? And was it
translated to the national language in Ethiopia, or they kept it in English language?
Line 148: some variables are confusing; the authors included students in health departments
which might already have good knowledge about breast screening which bias the results. Also,
the authors mentioned this variable “love engagement” do they mean marital status? And what
is the meaning of this variable “chat chewing”, and what chronic disease the authors mean by
this variable “chronic disease”.
Line 157: “Sleeping problem” the authors relied on participants responses in this question which
might be not accurate; this should be mentioned in the limitations section.
Line 164: “greater than the mean score were considered to have good breast cancer screening
practices” the mean score should be mentioned clearly.
Line 181: Data quality control: is this a repeated paragraph of the pilot study paragraph?
Results:
The authors should revise tables ligands as they do not match the ones in the results section.
Discussion:
This section needs to be written by a professional medical provider as the provided section is
just repeating the results and comparing it to other studies results without giving explanations.
Limitations:
This section it poorly written; the authors should mention the fact about the inclusion criteria
which I provided above; also, the fact that this study included health department students which
affect the data; also, the fact about sample size was not calculated.