Reviewer ’s report  
 
Title: Breast cancer screening practices of African migrant women in Australia: a descriptive 
cross -sectional study  
 
Version: 0 Date: 26 Oct 2016  
 
Reviewer: Sheri Hartman  
 
Reviewer's report:  
 
This is a well written manuscript exploring an important topic of breast cancer screening among 
African Migrants. Despite the interest for the topic I hav e some major concerns about the 
manuscript.  Specific questions are detailed below:  
1. Do you have access to any more recent statistics about number of migrants from Africa are 
in Australia?  
 
2. I was surprised to read that you did not have to get signed co nsent from your participants.  I 
was also concerned that you have participants who completed your English questionnaire 
that stated they were not proficient in English.  What did you do to ensure that the study was 
carried out ethically?  
 
3. In the measures , how was it determined that a score of 65 or higher indicated positive 
attitudes?  Any concern about the validity of the measures among the women with lower 
English proficiency?  
 
4. What is the purpose of presenting mammography results for the entire group  when many 
would not be expected to have a mammogram based on their age?  I appreciate that at some 
points you do limit the analyses related to just women for who mammograms are 
recommended but it might be helpful to limit all analyses (Table 3 & 4 for exa mple) or be 
clear which are and are not limited.   
 
5. Result write -up is confusing as it states that both annual and bi -annual screening are 
recommended.  It might be helpful to frame what recommendations are being used, if more 
than 1 is being used.  Reco mmendations vary by country and by method (mammogram, self -
exam, clinical exam).  
 
6. In the discussion you lead with only 11.4% practice self -exams.  In the US self -exams are 
not part of many recommendations anymore, so I wonder what the Australian 
recommen dations are and if this should be the finding you lead with.  Also the discussion is 
lacking citations to support statements about breast awareness being important for early 
detection.  
 
7. Sample seems pretty highly educated, with most being in Australia fo r longer than 5 years, 
any concerns about generalizability of these findings?  
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.  
 
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 spec ify 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:  
 
Acceptable  
 
Declaration of competing interests  
Pleas e 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 publicatio n of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares 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 received 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 othe r 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 acc epted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
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which I do not wish to be included in my named report can be included as confidential comments  
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I agree to the open peer review policy of the journal