Reviewer’ s report
Title: Value of Routine Test for Identifying Colorectal Cancer from Patients with Nonalcoholic
Fatty Liver Disease
Version: 0Date: 08 Jul 2019
Reviewer: Ridhi Gupta
Reviewer's report:
NAFLD and association of colonic neoplasms This is a big data analysis comparing the incidence
of CRC in patients with/without NAFLD and the general population. This is a good study withlarge data set but the biggest flaw in the study is the additional risk factors for colon cancer whichis different from those for fatty liver. These advent been taken into account - smoking , familyhistory etc. Also, the lab values to monitor in the NAFLD that increase the suspicion for coloncancer appear to be similar to that see in patients with CRC with/without NAFLD such as anemia,thrombocytosis. Abstract - well summarized but the results section - the last line needs to berephrased. Not sure what that means. ' No significant difference has not been found in otherindicators.' Also, in the result section - multiple CBC and CMP variables have been mentioned andits been mentioned as these are significantly different, please mention how?Introduction - there area few grammatical errors in sentence construction that need correction. 2.2 - Collecting andProcessing data - variable to be collected are mentioned but not in standard short forms. Eg.Mono_per . These are locally used / hospital or country used abbreviations. Please use eitherstandard abbreviations allowed by the journal or mention these as full first and then use asabbreviations.Also, etc cannot be used. Please define the different variables uses. Also what alldoes NAFLD include ? Fatty liver / hepatitis / cirrhosis ?4.1 - statement that NAFLD is associated
with an increased risk of CRC is unclear. So is NAFLD an association or a causation of CRC?4.1
line 190-194 - the likely causation of NAFLD and CRC needs to be better explained. 4.2 line 211-213 - recommendation are being made to reduce age for screening for CRC to 40 years and thatyour study supports that to. Please share data to support this finding here 4.2 line 232 - 'Furthercolonoscopy is necessary for people over 85 years with the decrease of MCV requires' - not surewhat this means 4.2 Line 251 - 254 - the comparison groups are NAFLD CRC v/s NAFLD - NonCRC. Platelet count is higher because of CRC, is a known fact that has been mentioned in yourarticle above. Please compare the platelet count for NALFD-CRC and General population - CRC.this will factor in the effect of NAFLD on platelet count. In conclusion, please mention a summaryof your findings in terms of suggestions for the reader to keep in mind when reviewing the labs fora NAFLD to screen for or suspect CRC. The conclusion is vague and not concrete. please mentiondrawbacks in your study as wellm
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.
YesAre 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 specify what aspects require furtherassessment in your comments to the editors.
I recommend additional statistical reviewQuality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being publishedDeclaration of competing interests
Please 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 publication of thismanuscript, 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 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 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 accepted for publication, my named reportincluding any attachments I upload will be posted on the website along with the authors'responses. I agree for my report to be made available under an Open Access Creative CommonsCC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any commentswhich I do not wish to be included in my named report can be included as confidential commentsto the editors, which will not be published.
I agree to the open peer review policy of the journal
Reviewer’ s report
Title: Value of Routine Test for Identifying Colorectal Cancer from Patients with Nonalcoholic
Fatty Liver Disease
Version: 0Date: 08 Jul 2019
Reviewer: Ridhi Gupta
Reviewer's report:
NAFLD and association of colonic neoplasms This is a big data analysis comparing the incidence
of CRC in patients with/without NAFLD and the general population. This is a good study withlarge data set but the biggest flaw in the study is the additional risk factors for colon cancer whichis different from those for fatty liver. These advent been taken into account - smoking , familyhistory etc. Also, the lab values to monitor in the NAFLD that increase the suspicion for coloncancer appear to be similar to that see in patients with CRC with/without NAFLD such as anemia,thrombocytosis. Abstract - well summarized but the results section - the last line needs to berephrased. Not sure what that means. ' No significant difference has not been found in otherindicators.' Also, in the result section - multiple CBC and CMP variables have been mentioned andits been mentioned as these are significantly different, please mention how?Introduction - there area few grammatical errors in sentence construction that need correction. 2.2 - Collecting andProcessing data - variable to be collected are mentioned but not in standard short forms. Eg.Mono_per . These are locally used / hospital or country used abbreviations. Please use eitherstandard abbreviations allowed by the journal or mention these as full first and then use asabbreviations.Also, etc cannot be used. Please define the different variables uses. Also what alldoes NAFLD include ? Fatty liver / hepatitis / cirrhosis ?4.1 - statement that NAFLD is associated
with an increased risk of CRC is unclear. So is NAFLD an association or a causation of CRC?4.1
line 190-194 - the likely causation of NAFLD and CRC needs to be better explained. 4.2 line 211-213 - recommendation are being made to reduce age for screening for CRC to 40 years and thatyour study supports that to. Please share data to support this finding here 4.2 line 232 - 'Furthercolonoscopy is necessary for people over 85 years with the decrease of MCV requires' - not surewhat this means 4.2 Line 251 - 254 - the comparison groups are NAFLD CRC v/s NAFLD - NonCRC. Platelet count is higher because of CRC, is a known fact that has been mentioned in yourarticle above. Please compare the platelet count for NALFD-CRC and General population - CRC.this will factor in the effect of NAFLD on platelet count. In conclusion, please mention a summaryof your findings in terms of suggestions for the reader to keep in mind when reviewing the labs fora NAFLD to screen for or suspect CRC. The conclusion is vague and not concrete. please mentiondrawbacks in your study as wellm
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.
YesAre 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 specify what aspects require furtherassessment in your comments to the editors.
I recommend additional statistical reviewQuality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being publishedDeclaration of competing interests
Please 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 publication of thismanuscript, 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 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 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 accepted for publication, my named reportincluding any attachments I upload will be posted on the website along with the authors'responses. I agree for my report to be made available under an Open Access Creative CommonsCC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any commentswhich I do not wish to be included in my named report can be included as confidential commentsto the editors, which will not be published.
I agree to the open peer review policy of the journal
Please review this paper.
user
Reviewer’ s report
Title: Value of Routine Test for Identifying Colorectal Cancer from Patients with Nonalcoholic
Fatty Liver Disease
Version: 0Date: 08 Jul 2019
Reviewer: Ridhi Gupta
Reviewer's report:
NAFLD and association of colonic neoplasms This is a big data analysis comparing the incidence
of CRC in patients with/without NAFLD and the general population. This is a good study withlarge data set but the biggest flaw in the study is the additional risk factors for colon cancer whichis different from those for fatty liver. These advent been taken into account - smoking , familyhistory etc. Also, the lab values to monitor in the NAFLD that increase the suspicion for coloncancer appear to be similar to that see in patients with CRC with/without NAFLD such as anemia,thrombocytosis. Abstract - well summarized but the results section - the last line needs to berephrased. Not sure what that means. ' No significant difference has not been found in otherindicators.' Also, in the result section - multiple CBC and CMP variables have been mentioned andits been mentioned as these are significantly different, please mention how?Introduction - there area few grammatical errors in sentence construction that need correction. 2.2 - Collecting andProcessing data - variable to be collected are mentioned but not in standard short forms. Eg.Mono_per . These are locally used / hospital or country used abbreviations. Please use eitherstandard abbreviations allowed by the journal or mention these as full first and then use asabbreviations.Also, etc cannot be used. Please define the different variables uses. Also what alldoes NAFLD include ? Fatty liver / hepatitis / cirrhosis ?4.1 - statement that NAFLD is associated
with an increased risk of CRC is unclear. So is NAFLD an association or a causation of CRC?4.1
line 190-194 - the likely causation of NAFLD and CRC needs to be better explained. 4.2 line 211-213 - recommendation are being made to reduce age for screening for CRC to 40 years and thatyour study supports that to. Please share data to support this finding here 4.2 line 232 - 'Furthercolonoscopy is necessary for people over 85 years with the decrease of MCV requires' - not surewhat this means 4.2 Line 251 - 254 - the comparison groups are NAFLD CRC v/s NAFLD - NonCRC. Platelet count is higher because of CRC, is a known fact that has been mentioned in yourarticle above. Please compare the platelet count for NALFD-CRC and General population - CRC.this will factor in the effect of NAFLD on platelet count. In conclusion, please mention a summaryof your findings in terms of suggestions for the reader to keep in mind when reviewing the labs fora NAFLD to screen for or suspect CRC. The conclusion is vague and not concrete. please mentiondrawbacks in your study as wellm
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.
YesAre 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 specify what aspects require furtherassessment in your comments to the editors.
I recommend additional statistical reviewQuality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being publishedDeclaration of competing interests
Please 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 publication of thismanuscript, 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 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 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 accepted for publication, my named reportincluding any attachments I upload will be posted on the website along with the authors'responses. I agree for my report to be made available under an Open Access Creative CommonsCC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any commentswhich I do not wish to be included in my named report can be included as confidential commentsto the editors, which will not be published.
I agree to the open peer review policy of the journal
assistant