Reviewer’s report
Title: 
Follow-up colonoscopy after an abnormal stool-based colorectal cancer
screening result: Analysis of steps in the colonoscopy completion process
Version: 
0 
Date: 
12 Aug 2021
Reviewer's report:
This retrospective study assessed the one-year colonoscopy referral rate of 711
patients who had an abnormal FIT result between August 5, 2017 and August 4,
2018.
No exclusions were applied. Of the 711 patients with an abnormal FIT result,
90% were referred to colonoscopy. 
Outcomes included rates of referral to colonoscopy, completion of a pre-
procedure visit, completion of a follow-up colonoscopy procedure, and time to
follow-up colonoscopy 
completion. Ninety percent of patients with abnormal FIT were referred to a GI
clinic, 52% attended a pre-procedure visit and 43% completed a colonoscopy
within the year following their abnormal FIT result (median time to
colonoscopy: 83 days).
The Authors would encourage health centers to improve follow-up colonoscopy
uptake, in order to reduce time to colonoscopy receipt, and save lives from
colorectal cancer.
Efforts are particularly needed for patients aged 65 and older, those who lack
health insurance, and those who have not attended a clinic visit in the year prior
to an abnormal FIT result.
The paper is clear, fluid and well written. Good statistical analysis.
Colonoscopy is the preferred CRC screening strategy and the undisputed gold
standard in terms of efficacy.
The findings of the study suggest that more than accelerating scheduling delays,
attention should be paid to increase the rate of patients completing a colonoscopy
after an abnormal FIT result.
The intent of the manuscript is noble and remarkable.
On the opposite, the paper lacks of advices/practical recommendations to reach
the goal.
"Improving the documentation of reasons for no follow-up could better inform
future interventions to improve follow-up care".
The Authors raise valid and reasonable questions.
Solutions should be implemented to reach a satisfactory evaluation.
Publons Reviewer Recognition
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Yes
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?
No
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
Reviewer’s report
Title: 
Follow-up colonoscopy after an abnormal stool-based colorectal cancer
screening result: Analysis of steps in the colonoscopy completion process
Version: 
0 
Date: 
12 Aug 2021
Reviewer's report:
This retrospective study assessed the one-year colonoscopy referral rate of 711
patients who had an abnormal FIT result between August 5, 2017 and August 4,
2018.
No exclusions were applied. Of the 711 patients with an abnormal FIT result,
90% were referred to colonoscopy. 
Outcomes included rates of referral to colonoscopy, completion of a pre-
procedure visit, completion of a follow-up colonoscopy procedure, and time to
follow-up colonoscopy 
completion. Ninety percent of patients with abnormal FIT were referred to a GI
clinic, 52% attended a pre-procedure visit and 43% completed a colonoscopy
within the year following their abnormal FIT result (median time to
colonoscopy: 83 days).
The Authors would encourage health centers to improve follow-up colonoscopy
uptake, in order to reduce time to colonoscopy receipt, and save lives from
colorectal cancer.
Efforts are particularly needed for patients aged 65 and older, those who lack
health insurance, and those who have not attended a clinic visit in the year prior
to an abnormal FIT result.
The paper is clear, fluid and well written. Good statistical analysis.
Colonoscopy is the preferred CRC screening strategy and the undisputed gold
standard in terms of efficacy.
The findings of the study suggest that more than accelerating scheduling delays,
attention should be paid to increase the rate of patients completing a colonoscopy
after an abnormal FIT result.
The intent of the manuscript is noble and remarkable.
On the opposite, the paper lacks of advices/practical recommendations to reach
the goal.
"Improving the documentation of reasons for no follow-up could better inform
future interventions to improve follow-up care".
The Authors raise valid and reasonable questions.
Solutions should be implemented to reach a satisfactory evaluation.
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
Yes
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?
No
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
Please review this paper.
user
Reviewer’s report
Title: 
Follow-up colonoscopy after an abnormal stool-based colorectal cancer
screening result: Analysis of steps in the colonoscopy completion process
Version: 
0 
Date: 
12 Aug 2021
Reviewer's report:
This retrospective study assessed the one-year colonoscopy referral rate of 711
patients who had an abnormal FIT result between August 5, 2017 and August 4,
2018.
No exclusions were applied. Of the 711 patients with an abnormal FIT result,
90% were referred to colonoscopy. 
Outcomes included rates of referral to colonoscopy, completion of a pre-
procedure visit, completion of a follow-up colonoscopy procedure, and time to
follow-up colonoscopy 
completion. Ninety percent of patients with abnormal FIT were referred to a GI
clinic, 52% attended a pre-procedure visit and 43% completed a colonoscopy
within the year following their abnormal FIT result (median time to
colonoscopy: 83 days).
The Authors would encourage health centers to improve follow-up colonoscopy
uptake, in order to reduce time to colonoscopy receipt, and save lives from
colorectal cancer.
Efforts are particularly needed for patients aged 65 and older, those who lack
health insurance, and those who have not attended a clinic visit in the year prior
to an abnormal FIT result.
The paper is clear, fluid and well written. Good statistical analysis.
Colonoscopy is the preferred CRC screening strategy and the undisputed gold
standard in terms of efficacy.
The findings of the study suggest that more than accelerating scheduling delays,
attention should be paid to increase the rate of patients completing a colonoscopy
after an abnormal FIT result.
The intent of the manuscript is noble and remarkable.
On the opposite, the paper lacks of advices/practical recommendations to reach
the goal.
"Improving the documentation of reasons for no follow-up could better inform
future interventions to improve follow-up care".
The Authors raise valid and reasonable questions.
Solutions should be implemented to reach a satisfactory evaluation.
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
Yes
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?
No
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
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