Reviewer ’s report  
 
Title: Association between obesity and abnormal Papanicolau(Pap) smear cytology results in a  
resource -poor Nigerian setting  
 
Version: 1 Date: 15 Jul 2019  
 
Reviewer: Shang -ying Hu  
 
Reviewer's report:  
 
This paper addressed the association between obesity and cervical epithelial cell abnormalities. 
However, there are several shortcomings to this study.  
 
Major comments:  
1. What was the procedure of recruitment? If the informed consent was done before physical and 
gynecological exams, it was incredible to just recruit the eligible women with obesity and non -
obesity in the ratio of 1:1. I understood that it was th e result of matched sampling. But the 
manuscript didn't describe it clearly, including individual/frequency matching method.  
2. Only univariate analyses were done in Table 4. Although matching sampling method had been 
used, multiply analysis was essential  for evaluation of risk factors. And what's more, the obesity 
status also should be considered as a covariate.  
3. HPV infection status was not considered in this study. It would lead to a big bias for this 
analysis.  
 
Minor comments:  
1. The article also had  some minor grammar error.  
2. Table 4: % of socio -demographic characteristics in cervical abnormality/ Uncervical 
abnormality groups should be calculated.  
3. In results part, "Among the 200 obese women, …, while 18 had CEA" and "Table 2 shows the 
Pap smear  cytology,….,18 (9%) of them had CEA". Those two sentences were duplicated.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
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.  
 
No 
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:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following question s: 
 
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 sha res in an 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 re ceived reimbursements, 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.  
 
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