Title: Cervical cancer screening utilization and associated factors among women attending
Antenatal Care at Asella Referral and Teaching Hospital, Arsi zone, South Ethiopia
Version: 2 Date: 20 Feb 2023
Reviewer's report:
It is good that the author's interested in the utilization screening of cervical cancer. Ethiopian
health statistics figures declared that cervical cancer is ranked second among all cancer types.
For most low and middle-income countries, prevention is the cheapest and the only way out of
such conditions as cancer and other NCDs that need expensive treatment.
point by point
Reviewer's comments
It is good that the author's interested in the utilization screening of cervical cancer. Ethiopian
health statistics figures declared that cervical cancer is ranked second among all cancer types.
For most low and middle-income countries, prevention is the cheapest and the only way out of
such conditions as cancer and other NCDs that need expensive treatment.
Title:
• Utilization of cervical cancer screening guidelines used by the physician.
• ANC attendants better studied their adherence to the service or the practice.
• Therefore, the title should be better shaped as "Utilization of cervical cancer screening
guidelines and its associated factors among mothers attending ANC"
• Does the ANC package provide pre-cervical cancer screening? If yes, good.
• In most referral hospitals we have a separate room for pre-cervical cancer screening designated
room for symptomatically as well asymptomatically.
Abstract
• Introduction: It shouldn't be more than 300 words, Line 24-26, needs rephrasing, Line 26-27,
You better place this statement into your recommendation.,
• Method: Avoid such words as we, they or you. Since cross-sectional is one point collection of
data, why from Dec to Feb, is it a longitudinal or follow-up study?
• Result: Make it readers' friendly, needs rephrasing. Remove it or rewrite it because you already
have at the closure of your abstract result
• Conclusion: How low? what was your reference or benchmark
Introduction
Line 57: Don't put figures like this, just say half a million or another way possible
Line 58: What does CC stand for?
Line 61: Lack connectivity, leading to this much per cent death as a failure to prevent it
Line 64: You should put the recently reported figure, as the second prevalent case, next to breast
ca
Line 67: where is Citation?
Line 74: You should have taken this paragraph next to the global figures
Keep consistency CC or CCS or coverage of CCS
Lines 83-90: avoid redundancy of this "………the factors affecting the utilization of CCS".
Line 98-99: You should have elaborated in detail on the types of cervical cancer screening
modalities
Line 106-107: Remove it, you are just repeating it.
Methods
• It should be study setting, design and period
• Populations should be in separate heading, as it includes source, study populations, including
inclusion and exclusion criteria
• Why did it take 3 months for a cross-sectional study
• How far is the Arsi zone from the capital city?
• You better put it in a separate section as sample size determination and sampling procedure.
• Authors used this study to calculate their sample size, "Knowledge, Attitude and Practice
towards Cervical Cancer Screening among Women and Associated Factors in Hospitals of
Wolaita Zone, Southern Ethiopia". They used only the practice, is it the same as the utilization
of CCS?
• Variables: it is not necessary, it has already been addressed in the result description section
Line 164: you shouldn't have written this (instruments, personnel, measurements). To be
explained in the manuscript
Line 178: Where is the data quality control section? Put it in separate
Line 183: how did you treat your outcome variables? How did you dichotomise it? Needs some
elaboration yes/no, etc
Result
Line 191: You should put the figure and the percentage together, what proportion is 98%? When
writing the result section avoid unnecessary details that are already in the table. Focus on the
major points.
Table 1: What was the reference for classifying ages below or above 35 years? The superscripts
in the table and the footnotes are mismatched. Letter with a number?
Table 4: on your table description you said 'subject'. what is the difference between the subject
and participants? Keep consistency throughout your manuscript. The title should be self-
explanatory.
Line 265: What is your confidence interval? to say below or above this result? You just said
"while only 33(10.6%) had undergone screening for CC in their lifetime"
Figure: Don't use figure caption in the manuscript. you should have embedded your figure in
your manuscript
Discussion
Authors should put a confidence interval. It is difficult to determine the highest or lowest point.
You must run bootstrapping to determine this unless you can't just discuss it haphazardly.
Line 344: Put your limitations separately,
Line 346: What do you mean? What did you observe?
Line 366: Where is your IRB ref protocol number for this particular study?