Reviewer's report
Title:Do high risk patients alter their lifestyle to reduce risk of colorectal cancer?
An observational study
Version: 1Date:26 September 2013
Reviewer: Annie Anderson
Reviewer's report:
This paper reports interesting work on perceived risk of CRC and reported
changes in lifestyle.
There are a number of issues to address
Major
1. The details of the collection tool are provided elsewhere but some information
is required to assess the current manuscript e.g the reliability and validity of the
tool to collect data on reported changes. There are three relevant issues here a)
How were questions phrased with respect to the time frame ?b) what magnitude
of change was reported (and ofcouse what is the validation) c) how was the “not
applicable” category dealt with (e.g. no changes in smoking because participant
did not smoke, or drink alcohol etc)
2. There are a number of papers reporting qualitative issues related to population
colorectal cancer screening (and adenoma bearers)and lifestyle highlighting low
awareness of risk and these should be cited in the discussion rather than
references to breast cancer risk. Overall authors seem to steer away from
qualitative literature but the following papers would contribute to discussion.
Qualitative papers- low risk awareness
Stead M, Caswell S, Craigie AM, Eadie D, Anderson AS; BeWEL team.
Understanding the potential and challenges of adenoma treatment as a
prevention opportunity: insights from the BeWEL formative study. Prev Med
2012;54(1):97–103.
Dowswell G, Ryan A, Taylor A et al. Designing an intervention to help people
with colorectal adenomas reduce their intake of red and processed meat and
increase their levels of physical activity: a qualitative study. BMC Cancer
2012;12:255.
3. In text the authors refer to reference 9 to support the statement that “patients
may adopt healthy behaviours around the time of CRC screening, but this
reference appears to relate to breast cancer screening
4. Page 11 authors suggest that risk of crc per se is important for promoting
change without medical professional intervention, but I am not sure if we can be
confident that no advice was given. In our family history clinics all patients get a
booklet about relevant lifestyle
5. The final para of discussion needs re-writing
6. There are two possible additions to the discussion… because people report
subjective lifestyle change it does not mean they achieve a relevant magnitude of
change to meet current guidance for that healthy behaviour (even in people who
say changed “very much so”), so prompting change in itself is rarely likely to be
adequate and additionally it may not be sustained. The opportunity “ teachable
moment” for health professionals to promote lifestyle change should also be
discussed.
Minor
7. The figures should each have a title
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
i declare that I have no competing interest
Reviewer's report
Title:Do high risk patients alter their lifestyle to reduce risk of colorectal cancer?
An observational study
Version: 1Date:26 September 2013
Reviewer: Annie Anderson
Reviewer's report:
This paper reports interesting work on perceived risk of CRC and reported
changes in lifestyle.
There are a number of issues to address
Major
1. The details of the collection tool are provided elsewhere but some information
is required to assess the current manuscript e.g the reliability and validity of the
tool to collect data on reported changes. There are three relevant issues here a)
How were questions phrased with respect to the time frame ?b) what magnitude
of change was reported (and ofcouse what is the validation) c) how was the “not
applicable” category dealt with (e.g. no changes in smoking because participant
did not smoke, or drink alcohol etc)
2. There are a number of papers reporting qualitative issues related to population
colorectal cancer screening (and adenoma bearers)and lifestyle highlighting low
awareness of risk and these should be cited in the discussion rather than
references to breast cancer risk. Overall authors seem to steer away from
qualitative literature but the following papers would contribute to discussion.
Qualitative papers- low risk awareness
Stead M, Caswell S, Craigie AM, Eadie D, Anderson AS; BeWEL team.
Understanding the potential and challenges of adenoma treatment as a
prevention opportunity: insights from the BeWEL formative study. Prev Med
2012;54(1):97–103.
Dowswell G, Ryan A, Taylor A et al. Designing an intervention to help people
with colorectal adenomas reduce their intake of red and processed meat and
increase their levels of physical activity: a qualitative study. BMC Cancer
2012;12:255.
3. In text the authors refer to reference 9 to support the statement that “patients
may adopt healthy behaviours around the time of CRC screening, but this
reference appears to relate to breast cancer screening
4. Page 11 authors suggest that risk of crc per se is important for promoting
change without medical professional intervention, but I am not sure if we can be
confident that no advice was given. In our family history clinics all patients get a
booklet about relevant lifestyle
5. The final para of discussion needs re-writing
6. There are two possible additions to the discussion… because people report
subjective lifestyle change it does not mean they achieve a relevant magnitude of
change to meet current guidance for that healthy behaviour (even in people who
say changed “very much so”), so prompting change in itself is rarely likely to be
adequate and additionally it may not be sustained. The opportunity “ teachable
moment” for health professionals to promote lifestyle change should also be
discussed.
Minor
7. The figures should each have a title
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
i declare that I have no competing interest
Please review this paper.
user
Reviewer's report
Title:Do high risk patients alter their lifestyle to reduce risk of colorectal cancer?
An observational study
Version: 1Date:26 September 2013
Reviewer: Annie Anderson
Reviewer's report:
This paper reports interesting work on perceived risk of CRC and reported
changes in lifestyle.
There are a number of issues to address
Major
1. The details of the collection tool are provided elsewhere but some information
is required to assess the current manuscript e.g the reliability and validity of the
tool to collect data on reported changes. There are three relevant issues here a)
How were questions phrased with respect to the time frame ?b) what magnitude
of change was reported (and ofcouse what is the validation) c) how was the “not
applicable” category dealt with (e.g. no changes in smoking because participant
did not smoke, or drink alcohol etc)
2. There are a number of papers reporting qualitative issues related to population
colorectal cancer screening (and adenoma bearers)and lifestyle highlighting low
awareness of risk and these should be cited in the discussion rather than
references to breast cancer risk. Overall authors seem to steer away from
qualitative literature but the following papers would contribute to discussion.
Qualitative papers- low risk awareness
Stead M, Caswell S, Craigie AM, Eadie D, Anderson AS; BeWEL team.
Understanding the potential and challenges of adenoma treatment as a
prevention opportunity: insights from the BeWEL formative study. Prev Med
2012;54(1):97–103.
Dowswell G, Ryan A, Taylor A et al. Designing an intervention to help people
with colorectal adenomas reduce their intake of red and processed meat and
increase their levels of physical activity: a qualitative study. BMC Cancer
2012;12:255.
3. In text the authors refer to reference 9 to support the statement that “patients
may adopt healthy behaviours around the time of CRC screening, but this
reference appears to relate to breast cancer screening
4. Page 11 authors suggest that risk of crc per se is important for promoting
change without medical professional intervention, but I am not sure if we can be
confident that no advice was given. In our family history clinics all patients get a
booklet about relevant lifestyle
5. The final para of discussion needs re-writing
6. There are two possible additions to the discussion… because people report
subjective lifestyle change it does not mean they achieve a relevant magnitude of
change to meet current guidance for that healthy behaviour (even in people who
say changed “very much so”), so prompting change in itself is rarely likely to be
adequate and additionally it may not be sustained. The opportunity “ teachable
moment” for health professionals to promote lifestyle change should also be
discussed.
Minor
7. The figures should each have a title
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
i declare that I have no competing interest
assistant