Reviewer’s report
Title: 
Trend of geographical distribution of stomach cancer in Iran from 2004-
2014
Version: 
0 
Date: 
22 Feb 2021
Reviewer's report:
Please include all comments for the authors in this box rather than uploading
your report as an attachment. Please only upload as attachments annotated
versions of manuscripts, graphs, supporting materials or other aspects of your
report which cannot be included in a text format.
Please overwrite this text when adding your comments to the authors.
General Comment. 
This manuscript titled "Trend of geographical distribution of stomach cancer in
Iran from 2004-2014" is a descriptive work, which shows the geographic pattern
of gastric cancer (GC) in Iran.
It uses mapping techniques to illustrate the spatial distribution of GC incidence
rates. As the authors mention, the results are useful information to better
understand the etiology of the disease.
Unfortunately, the authors do not report any results regarding to some possible
conditioning factors of incidence pattern, such as the distribution of Helicobacter
pylor infection or dietary and nutritional habits, including environmental ones,
recognized as promoters of the occurrence. This limits the scope of the
inferences and apparently biases the discussion that the authors present in the
last section.
Background:
Please, update these references. Please update the references. The authors cite
that in the year 2020 .... (page 2, line 30) and use a 2016' publicatio. 
There is abundant and updated bibliography about the epidemiology of gastric
cancer, the authors should make an effort to achieve a more interesting
introduction in this regard.
In my opnion, authors use and abuse 
two or three references in the background
item and that detracts from the quality of 
work.
Methods:
The period of study was 2004-2014. Why the authors did use provinces
population from the 2012 national census? 
They should have used a previous census, their intermediate projections, and the
2012 census. This is an important issue for calculating incidence rates.
The authors do not mention how they calculate incidence rates over time. Is it
annual? for five years? In the next item refer to the rates joining 10 years. why?
Is it due to the instability of the casuistry that the tumor registry receives? With
this decision, the authors lose the possibility of describing the longitudinal
pattern in time associated with the spatial pattern.
The authors could have estimated indices to identify spatial aggregation, or non-
randomness of the occurrence of GC.
How do the authors verify the differences between the rates? 
Which test or statistical model did they use? the statistical aspects are poorly
described. 
This methodological aspect is very incomplete.
Results:
The third paragraph of Results 
cannot be understood since the statistical tools to
achieve these results are not explicit.
Tables and figures should be improved in their design and edition.
Discussion:
The Discussion is very ambitious in terms of the results obtained and far exceeds
the inferences made. As I mentioned previously, this is a purely descriptive work
and the authors should consider the limitations of the results achieved. Although
it is extremely useful information for the Public Health of the country studied, it
is necessary to have other studies to justify some of the lines outlined in this
section.
Reference:
References must be checked.
Publons Reviewer Recognition
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find the details of processing in Publons’ privacy policy
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No
Declaration 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 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 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.
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
No
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
No
Reviewer’s report
Title: 
Trend of geographical distribution of stomach cancer in Iran from 2004-
2014
Version: 
0 
Date: 
22 Feb 2021
Reviewer's report:
Please include all comments for the authors in this box rather than uploading
your report as an attachment. Please only upload as attachments annotated
versions of manuscripts, graphs, supporting materials or other aspects of your
report which cannot be included in a text format.
Please overwrite this text when adding your comments to the authors.
General Comment. 
This manuscript titled "Trend of geographical distribution of stomach cancer in
Iran from 2004-2014" is a descriptive work, which shows the geographic pattern
of gastric cancer (GC) in Iran.
It uses mapping techniques to illustrate the spatial distribution of GC incidence
rates. As the authors mention, the results are useful information to better
understand the etiology of the disease.
Unfortunately, the authors do not report any results regarding to some possible
conditioning factors of incidence pattern, such as the distribution of Helicobacter
pylor infection or dietary and nutritional habits, including environmental ones,
recognized as promoters of the occurrence. This limits the scope of the
inferences and apparently biases the discussion that the authors present in the
last section.
Background:
Please, update these references. Please update the references. The authors cite
that in the year 2020 .... (page 2, line 30) and use a 2016' publicatio. 
There is abundant and updated bibliography about the epidemiology of gastric
cancer, the authors should make an effort to achieve a more interesting
introduction in this regard.
In my opnion, authors use and abuse 
two or three references in the background
item and that detracts from the quality of 
work.
Methods:
The period of study was 2004-2014. Why the authors did use provinces
population from the 2012 national census? 
They should have used a previous census, their intermediate projections, and the
2012 census. This is an important issue for calculating incidence rates.
The authors do not mention how they calculate incidence rates over time. Is it
annual? for five years? In the next item refer to the rates joining 10 years. why?
Is it due to the instability of the casuistry that the tumor registry receives? With
this decision, the authors lose the possibility of describing the longitudinal
pattern in time associated with the spatial pattern.
The authors could have estimated indices to identify spatial aggregation, or non-
randomness of the occurrence of GC.
How do the authors verify the differences between the rates? 
Which test or statistical model did they use? the statistical aspects are poorly
described. 
This methodological aspect is very incomplete.
Results:
The third paragraph of Results 
cannot be understood since the statistical tools to
achieve these results are not explicit.
Tables and figures should be improved in their design and edition.
Discussion:
The Discussion is very ambitious in terms of the results obtained and far exceeds
the inferences made. As I mentioned previously, this is a purely descriptive work
and the authors should consider the limitations of the results achieved. Although
it is extremely useful information for the Public Health of the country studied, it
is necessary to have other studies to justify some of the lines outlined in this
section.
Reference:
References must be checked.
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
No
Declaration 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 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 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.
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
No
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
No
Please review this paper.
user
Reviewer’s report
Title: 
Trend of geographical distribution of stomach cancer in Iran from 2004-
2014
Version: 
0 
Date: 
22 Feb 2021
Reviewer's report:
Please include all comments for the authors in this box rather than uploading
your report as an attachment. Please only upload as attachments annotated
versions of manuscripts, graphs, supporting materials or other aspects of your
report which cannot be included in a text format.
Please overwrite this text when adding your comments to the authors.
General Comment. 
This manuscript titled "Trend of geographical distribution of stomach cancer in
Iran from 2004-2014" is a descriptive work, which shows the geographic pattern
of gastric cancer (GC) in Iran.
It uses mapping techniques to illustrate the spatial distribution of GC incidence
rates. As the authors mention, the results are useful information to better
understand the etiology of the disease.
Unfortunately, the authors do not report any results regarding to some possible
conditioning factors of incidence pattern, such as the distribution of Helicobacter
pylor infection or dietary and nutritional habits, including environmental ones,
recognized as promoters of the occurrence. This limits the scope of the
inferences and apparently biases the discussion that the authors present in the
last section.
Background:
Please, update these references. Please update the references. The authors cite
that in the year 2020 .... (page 2, line 30) and use a 2016' publicatio. 
There is abundant and updated bibliography about the epidemiology of gastric
cancer, the authors should make an effort to achieve a more interesting
introduction in this regard.
In my opnion, authors use and abuse 
two or three references in the background
item and that detracts from the quality of 
work.
Methods:
The period of study was 2004-2014. Why the authors did use provinces
population from the 2012 national census? 
They should have used a previous census, their intermediate projections, and the
2012 census. This is an important issue for calculating incidence rates.
The authors do not mention how they calculate incidence rates over time. Is it
annual? for five years? In the next item refer to the rates joining 10 years. why?
Is it due to the instability of the casuistry that the tumor registry receives? With
this decision, the authors lose the possibility of describing the longitudinal
pattern in time associated with the spatial pattern.
The authors could have estimated indices to identify spatial aggregation, or non-
randomness of the occurrence of GC.
How do the authors verify the differences between the rates? 
Which test or statistical model did they use? the statistical aspects are poorly
described. 
This methodological aspect is very incomplete.
Results:
The third paragraph of Results 
cannot be understood since the statistical tools to
achieve these results are not explicit.
Tables and figures should be improved in their design and edition.
Discussion:
The Discussion is very ambitious in terms of the results obtained and far exceeds
the inferences made. As I mentioned previously, this is a purely descriptive work
and the authors should consider the limitations of the results achieved. Although
it is extremely useful information for the Public Health of the country studied, it
is necessary to have other studies to justify some of the lines outlined in this
section.
Reference:
References must be checked.
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
No
Declaration 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 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 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.
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
No
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
No
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