Title: Colorectal Polyp Prevalence and Adenoma Detection Rates in an Iranian Cohort: A
Prospective Study
Version: 1 Date: 21 Apr 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
I appreciate the authors’ thoughtful and comprehensive responses to the comments raised. The
revisions have strengthened the manuscript, and several concerns were adequately addressed,
particularly regarding the limitations of a single-center study and the rationale for participant
exclusions. The acknowledgment of ongoing follow-up studies is also appreciated.
However, I would recommend the manuscript undergo  revision to address the following
remaining points:
Confounding Variables:
While the authors acknowledged regional and lifestyle differences, the impact of other potential
confounding factors—such as family history of colorectal cancer, dietary habits, physical
activity, or genetic predispositions—remains insufficiently discussed. Even if these variables
were not collected, a brief mention of their potential influence and a suggestion for their inclusion
in future studies would improve the manuscript.
Histological Characteristics of Polyps:
The authors declined to elaborate further on the pathological characteristics of the polyps, citing
existing literature. While I understand this point, a concise summary of key histological features
(e.g., proportion of high-risk adenomas or those with dysplasia) would enhance the clinical
relevance of the findings and provide valuable context for readers, especially given the focus
on ADR and PDR.
Observer Bias in Pathology:
The explanation regarding the use of two GI pathologists is reasonable. Nonetheless, a brief
acknowledgment in the manuscript of the possibility of observer bias and the potential benefits
of blinded or additional reviews would provide a balanced perspective.
Title: Colorectal Polyp Prevalence and Adenoma Detection Rates in an Iranian Cohort: A
Prospective Study
Version: 1 Date: 21 Apr 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
I appreciate the authors’ thoughtful and comprehensive responses to the comments raised. The
revisions have strengthened the manuscript, and several concerns were adequately addressed,
particularly regarding the limitations of a single-center study and the rationale for participant
exclusions. The acknowledgment of ongoing follow-up studies is also appreciated.
However, I would recommend the manuscript undergo  revision to address the following
remaining points:
Confounding Variables:
While the authors acknowledged regional and lifestyle differences, the impact of other potential
confounding factors—such as family history of colorectal cancer, dietary habits, physical
activity, or genetic predispositions—remains insufficiently discussed. Even if these variables
were not collected, a brief mention of their potential influence and a suggestion for their inclusion
in future studies would improve the manuscript.
Histological Characteristics of Polyps:
The authors declined to elaborate further on the pathological characteristics of the polyps, citing
existing literature. While I understand this point, a concise summary of key histological features
(e.g., proportion of high-risk adenomas or those with dysplasia) would enhance the clinical
relevance of the findings and provide valuable context for readers, especially given the focus
on ADR and PDR.
Observer Bias in Pathology:
The explanation regarding the use of two GI pathologists is reasonable. Nonetheless, a brief
acknowledgment in the manuscript of the possibility of observer bias and the potential benefits
of blinded or additional reviews would provide a balanced perspective.
Please review this paper.
user
Title: Colorectal Polyp Prevalence and Adenoma Detection Rates in an Iranian Cohort: A
Prospective Study
Version: 1 Date: 21 Apr 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
I appreciate the authors’ thoughtful and comprehensive responses to the comments raised. The
revisions have strengthened the manuscript, and several concerns were adequately addressed,
particularly regarding the limitations of a single-center study and the rationale for participant
exclusions. The acknowledgment of ongoing follow-up studies is also appreciated.
However, I would recommend the manuscript undergo  revision to address the following
remaining points:
Confounding Variables:
While the authors acknowledged regional and lifestyle differences, the impact of other potential
confounding factors—such as family history of colorectal cancer, dietary habits, physical
activity, or genetic predispositions—remains insufficiently discussed. Even if these variables
were not collected, a brief mention of their potential influence and a suggestion for their inclusion
in future studies would improve the manuscript.
Histological Characteristics of Polyps:
The authors declined to elaborate further on the pathological characteristics of the polyps, citing
existing literature. While I understand this point, a concise summary of key histological features
(e.g., proportion of high-risk adenomas or those with dysplasia) would enhance the clinical
relevance of the findings and provide valuable context for readers, especially given the focus
on ADR and PDR.
Observer Bias in Pathology:
The explanation regarding the use of two GI pathologists is reasonable. Nonetheless, a brief
acknowledgment in the manuscript of the possibility of observer bias and the potential benefits
of blinded or additional reviews would provide a balanced perspective.
assistant