Reviewer ’s report  
 
Title: FARKOR: Evaluating the effects of a risk -adapted screening program for familial 
colorectal  cancer in individuals between 25 and 50 years of age in a prospective population -
based  intervention study  
 
Version: 0 Date: 30 Jun 2019  
 
Reviewer: Samantha Morais  
 
Reviewer's report:  
 
Minor editing throughout the article: avoid the use of "we" in the Background, 
Methods/Design; review the use of abbreviations; periods should be used to separate decimal 
places; verb tenses (should use the future in some sections of the manuscript conside ring that 
the study is ongoing and certain aspects will be carried out later).  
 
The abstract in the Manuscript Draft and the Manuscript text file are slightly different.  
 
The third paragraph of the Introduction "Over the past two decades, a general decline  in the 
incidence and mortality of CRC has been observed in many countries and this decline is 
mostly attributed to screening. At the same time, an increase in CRC incidence in individuals 
under 50 years is observed in some countries, in particular in the United States [9] and 
Australia [10]." is slightly repetitive of the ending of the previous paragraph in the 
Introduction.  
 
A few references should be added to the introduction:  
"While, there are estimates on the prevalence of CRC and of precancerous lesio ns in 
individuals with a family history of CRC, these estimates may suffer from an inconsistent 
treatment of individuals with hereditary forms of CRC."  
"Finally, there is evidence concerning the usefulness of questionnaires to determine family 
history of C RC in individuals under 50 years of age,"  
 
Is it possible for the authors to explain why Bavaria was chosen to implement/carry out this 
study? Are there certain specifications which call for a risk -adapted screening program for 
familial CRC in Bavaria?  
 
Please explain the use of insurance companies in the recruitment of participants as well as the 
statuary health insurance aspect of the study. This may not be immediately intuitive for non -
German readers.  
 
The steps described in the manuscript for Figure 1 ("The full FARKOR process is shown in 
Figure 1…") do not entirely match those showed in the figure. It would probably be helpful 
to use the same terms in both this description and in the figure. Is the onl ine lifestyle 
questionnaire part of Figure 1? That is not fully clear.  
 
The sentence "They represent the target population" should be incorparted into the previous 
sentence.  
 
A flow chart may be helpful to understand the sample size considerations describe d in the 
manuscript.  
 
The formatting of the references should be reviewed.  
 
 
 
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, pl ease 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 manuscr ipt 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 manuscript  
 
Quality of written Engl ish 
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursemen ts, 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 al l of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
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 report  including 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 
Commons  CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that 
any comments  which I do not wish to be included in my named report can be included as 
confidential comments  to the editors, which will not be published.  
 
I agre e to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: FARKOR: Evaluating the effects of a risk -adapted screening program for familial 
colorectal  cancer in individuals between 25 and 50 years of age in a prospective population -
based  intervention study  
 
Version: 0 Date: 30 Jun 2019  
 
Reviewer: Samantha Morais  
 
Reviewer's report:  
 
Minor editing throughout the article: avoid the use of "we" in the Background, 
Methods/Design; review the use of abbreviations; periods should be used to separate decimal 
places; verb tenses (should use the future in some sections of the manuscript conside ring that 
the study is ongoing and certain aspects will be carried out later).  
 
The abstract in the Manuscript Draft and the Manuscript text file are slightly different.  
 
The third paragraph of the Introduction "Over the past two decades, a general decline  in the 
incidence and mortality of CRC has been observed in many countries and this decline is 
mostly attributed to screening. At the same time, an increase in CRC incidence in individuals 
under 50 years is observed in some countries, in particular in the United States [9] and 
Australia [10]." is slightly repetitive of the ending of the previous paragraph in the 
Introduction.  
 
A few references should be added to the introduction:  
"While, there are estimates on the prevalence of CRC and of precancerous lesio ns in 
individuals with a family history of CRC, these estimates may suffer from an inconsistent 
treatment of individuals with hereditary forms of CRC."  
"Finally, there is evidence concerning the usefulness of questionnaires to determine family 
history of C RC in individuals under 50 years of age,"  
 
Is it possible for the authors to explain why Bavaria was chosen to implement/carry out this 
study? Are there certain specifications which call for a risk -adapted screening program for 
familial CRC in Bavaria?  
 
Please explain the use of insurance companies in the recruitment of participants as well as the 
statuary health insurance aspect of the study. This may not be immediately intuitive for non -
German readers.  
 
The steps described in the manuscript for Figure 1 ("The full FARKOR process is shown in 
Figure 1…") do not entirely match those showed in the figure. It would probably be helpful 
to use the same terms in both this description and in the figure. Is the onl ine lifestyle 
questionnaire part of Figure 1? That is not fully clear.  
 
The sentence "They represent the target population" should be incorparted into the previous 
sentence.  
 
A flow chart may be helpful to understand the sample size considerations describe d in the 
manuscript.  
 
The formatting of the references should be reviewed.  
 
 
 
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, pl ease 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 manuscr ipt 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 manuscript  
 
Quality of written Engl ish 
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursemen ts, 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 al l of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
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 report  including 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 
Commons  CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that 
any comments  which I do not wish to be included in my named report can be included as 
confidential comments  to the editors, which will not be published.  
 
I agre e to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: FARKOR: Evaluating the effects of a risk -adapted screening program for familial 
colorectal  cancer in individuals between 25 and 50 years of age in a prospective population -
based  intervention study  
 
Version: 0 Date: 30 Jun 2019  
 
Reviewer: Samantha Morais  
 
Reviewer's report:  
 
Minor editing throughout the article: avoid the use of "we" in the Background, 
Methods/Design; review the use of abbreviations; periods should be used to separate decimal 
places; verb tenses (should use the future in some sections of the manuscript conside ring that 
the study is ongoing and certain aspects will be carried out later).  
 
The abstract in the Manuscript Draft and the Manuscript text file are slightly different.  
 
The third paragraph of the Introduction "Over the past two decades, a general decline  in the 
incidence and mortality of CRC has been observed in many countries and this decline is 
mostly attributed to screening. At the same time, an increase in CRC incidence in individuals 
under 50 years is observed in some countries, in particular in the United States [9] and 
Australia [10]." is slightly repetitive of the ending of the previous paragraph in the 
Introduction.  
 
A few references should be added to the introduction:  
"While, there are estimates on the prevalence of CRC and of precancerous lesio ns in 
individuals with a family history of CRC, these estimates may suffer from an inconsistent 
treatment of individuals with hereditary forms of CRC."  
"Finally, there is evidence concerning the usefulness of questionnaires to determine family 
history of C RC in individuals under 50 years of age,"  
 
Is it possible for the authors to explain why Bavaria was chosen to implement/carry out this 
study? Are there certain specifications which call for a risk -adapted screening program for 
familial CRC in Bavaria?  
 
Please explain the use of insurance companies in the recruitment of participants as well as the 
statuary health insurance aspect of the study. This may not be immediately intuitive for non -
German readers.  
 
The steps described in the manuscript for Figure 1 ("The full FARKOR process is shown in 
Figure 1…") do not entirely match those showed in the figure. It would probably be helpful 
to use the same terms in both this description and in the figure. Is the onl ine lifestyle 
questionnaire part of Figure 1? That is not fully clear.  
 
The sentence "They represent the target population" should be incorparted into the previous 
sentence.  
 
A flow chart may be helpful to understand the sample size considerations describe d in the 
manuscript.  
 
The formatting of the references should be reviewed.  
 
 
 
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, pl ease 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 manuscr ipt 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 manuscript  
 
Quality of written Engl ish 
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursemen ts, 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 al l of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
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 report  including 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 
Commons  CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that 
any comments  which I do not wish to be included in my named report can be included as 
confidential comments  to the editors, which will not be published.  
 
I agre e to the open peer review policy of the journal  
assistant