Reviewer ’s report  
 
Title: Qualitative Assessment of Knowledge and Attitudes Towards Cervical Cancer Screening  
Among Male Latino Immigrants in Houston, Texas  
 
Version: 0 Date: 07 May 2020  
 
Reviewer's report:  
 
Thank you for the opportunity of reviewing this interesting study aim at evaluating a qualitative 
assessment of knowledge and attitudes towards cervical cancer screening among male latino 
immigrants in Houston.   The authors demonstrated with this qualitative study that the 
sensitization of the male partner regarding the use of the screening test for cervical cancer could 
be used with the goal of promoting cervical cancer screening among immigrant latinx  
populati ons. 
 
This study was conducted through the administration of a series of semi -structured, qualitative 
interviews. Interview questions were constructed using principles of the Theory of Reasoned 
Action.  
 
The manuscript is overall well written and the topic tr eated is of major interest. Indeed, as 
pointed out by the authors, it would be very important to analyse the perception of the 
importance of screening protocols in different patient populations. The possibility to sensitize 
male population to promote scree ning for cervical cancer in the female population is an 
extremely interesting strategy and a new perspective  
 
I have some minor suggestions and questions that I wish the authors could comment on.  
* Introduction: overall well written; I would add a more detailed description of the 
patients characteristics, such as the degree of education, characteristic that could influence the 
outcome of the investigation  
* Among the demographic data it would be inte resting to know if patients have received 
a strict religious education. These data are very important to clarify the results of this study.  
* I would add a more detailed description of the characteristics and the methods of the 
screening protocols: Papanic olau Test and the new DNA -HPV test.  
* It would be interesting to investigate the sexuality of the couple through the 
administration of questionnaires such the Female Sexual Function Index (FSFI). The fear of 
medical investigations and of disease in the par tner can create anxiety and generate somatization 
of the latter. A recent study shows that the presence of somatic symptoms can represent an 
important contextual factor in the determination of or in the exacerbation of male sexual 
dysfunction. The authors may consider to cite this paper in the discussion (PMID: 27555509)  
* Indeed would be interesting to investigate sexuality to detect female sexual 
dysfunctions, which prevents her from accessing in cervical cancer screening. Vaginismus can be 
cited in this regard. A recent exploratory analysis shows that Vaginismus was associated with 
histrionic -hysterical traits, FSFI pain domain, and sex -related distress.  The authors may consider 
to cite this paper in the discussion (PMID: 29110807)  
 
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.  
 
No 
 
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.  
 
Not relevant to this m anuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the follo wing 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 publication 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 other financial competing interests?  
 
6. Do you have any n on-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.  
 
1. NO2. NO3. NO4. NO5. NO6. NOI declare that I have no competing interests' below"  
 
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