Reviewer's report
Title:A shift from distal to proximal neoplasia in the colon: a decade of polyps
and CRC in Italy.
Version: 1Date:1 December 2009
Reviewer: Jose Martinez-Penuela
Reviewer's report:
Having finished my evaluation of the referred article, I would like to make some
comments and suggestions
Comments
- The subject of the article is an interesting one, it might have a relationship with
possible changes in screening programs and has been evaluated in scientific
works for some years now with conflicting results.
- The author has included a very high number of cases (3087), making the power
of statistical analysis a very high one.
- A high number of variables is analyzed, and the most important variables
related to the patient and to the tumour are included.
- The author also makes a good comparison of their results with other articles on
the same subject, and especially with the studies made within their own country.
- Bibliographic references are complete and actual.
Suggestions
It might have been interesting, as the authors indicate, to have had the chance to
define the characteristics of the colonoscopies in which the lesions were detected
(use of sedation, completeness of the colonoscopy, quality of the bowel
preparation in both groups). All these parameters have been related to a higher
detection of lesions and make for a much better endoscopical evaluation of the
proximal colon.
Considering that all adenomas were revised, serrated adenomas could have
been included in the study (because of their possible tendency to a more
proximal location) The quality of the study could also have been enhanced by
knowing data about the family history of the patients, in order to discard their
possible inclusion in risk groups (such as adenomatous polyposis or colo-rectal
carcinoma), but the author already describes this point as a limitation of the
study.
There is a typing mistake in the text, just before the conclusion. When talking
about high-risk population, patients with IRRITABLE BOWEL DISEASE are
included. I believe the authors really intended to say INFLAMMATORY BOWEL
DISEASE (which is truly included in the high-risk population)
In summary, I believe this is a good article and that it should be published. There
could be limitations in this study, but the author knows, accepts and describes
them, and states in the conclusion that these limitations should be considered
when planning or carrying out further studies on this subject
Reviewer's report
Title:A shift from distal to proximal neoplasia in the colon: a decade of polyps
and CRC in Italy.
Version: 1Date:1 December 2009
Reviewer: Jose Martinez-Penuela
Reviewer's report:
Having finished my evaluation of the referred article, I would like to make some
comments and suggestions
Comments
- The subject of the article is an interesting one, it might have a relationship with
possible changes in screening programs and has been evaluated in scientific
works for some years now with conflicting results.
- The author has included a very high number of cases (3087), making the power
of statistical analysis a very high one.
- A high number of variables is analyzed, and the most important variables
related to the patient and to the tumour are included.
- The author also makes a good comparison of their results with other articles on
the same subject, and especially with the studies made within their own country.
- Bibliographic references are complete and actual.
Suggestions
It might have been interesting, as the authors indicate, to have had the chance to
define the characteristics of the colonoscopies in which the lesions were detected
(use of sedation, completeness of the colonoscopy, quality of the bowel
preparation in both groups). All these parameters have been related to a higher
detection of lesions and make for a much better endoscopical evaluation of the
proximal colon.
Considering that all adenomas were revised, serrated adenomas could have
been included in the study (because of their possible tendency to a more
proximal location) The quality of the study could also have been enhanced by
knowing data about the family history of the patients, in order to discard their
possible inclusion in risk groups (such as adenomatous polyposis or colo-rectal
carcinoma), but the author already describes this point as a limitation of the
study.
There is a typing mistake in the text, just before the conclusion. When talking
about high-risk population, patients with IRRITABLE BOWEL DISEASE are
included. I believe the authors really intended to say INFLAMMATORY BOWEL
DISEASE (which is truly included in the high-risk population)
In summary, I believe this is a good article and that it should be published. There
could be limitations in this study, but the author knows, accepts and describes
them, and states in the conclusion that these limitations should be considered
when planning or carrying out further studies on this subject
Please review this paper.
user
Reviewer's report
Title:A shift from distal to proximal neoplasia in the colon: a decade of polyps
and CRC in Italy.
Version: 1Date:1 December 2009
Reviewer: Jose Martinez-Penuela
Reviewer's report:
Having finished my evaluation of the referred article, I would like to make some
comments and suggestions
Comments
- The subject of the article is an interesting one, it might have a relationship with
possible changes in screening programs and has been evaluated in scientific
works for some years now with conflicting results.
- The author has included a very high number of cases (3087), making the power
of statistical analysis a very high one.
- A high number of variables is analyzed, and the most important variables
related to the patient and to the tumour are included.
- The author also makes a good comparison of their results with other articles on
the same subject, and especially with the studies made within their own country.
- Bibliographic references are complete and actual.
Suggestions
It might have been interesting, as the authors indicate, to have had the chance to
define the characteristics of the colonoscopies in which the lesions were detected
(use of sedation, completeness of the colonoscopy, quality of the bowel
preparation in both groups). All these parameters have been related to a higher
detection of lesions and make for a much better endoscopical evaluation of the
proximal colon.
Considering that all adenomas were revised, serrated adenomas could have
been included in the study (because of their possible tendency to a more
proximal location) The quality of the study could also have been enhanced by
knowing data about the family history of the patients, in order to discard their
possible inclusion in risk groups (such as adenomatous polyposis or colo-rectal
carcinoma), but the author already describes this point as a limitation of the
study.
There is a typing mistake in the text, just before the conclusion. When talking
about high-risk population, patients with IRRITABLE BOWEL DISEASE are
included. I believe the authors really intended to say INFLAMMATORY BOWEL
DISEASE (which is truly included in the high-risk population)
In summary, I believe this is a good article and that it should be published. There
could be limitations in this study, but the author knows, accepts and describes
them, and states in the conclusion that these limitations should be considered
when planning or carrying out further studies on this subject
assistant