Title: Analysis of the effect of fecal SDC2, ADHFE1 and PPP2R5C gene methylation test for
screening colorectal cancer in the Otog Front Banner
Version: 0 Date: 14 Nov 2024
Reviewer's report:
Thank you for the opportunity to review the manuscript entitled “Analysis of the effect of fecal
SDC2, ADHFE1 and PPP2R5C gene methylation test for screening colorectal cancer in the
Otokqianqi area”. The aim of this study is clinically important. However, there are several
questions.
Major points
1. This study did not compare the efficacy of SDC2, ADHFE1, and PPP2R5C gene methylation
testing to another method, such as FIT. Thus, the results do not support the conclusion “SDC2,
ADHFE1, and PPP2R5C gene methylation testing can effectively detect CRC.” A comparison
with another method is mandatory to determine its efficacy. Please revise the conclusion
appropriately.
2. The reviewer could not understand the study design. Do all individuals in Otokqianqi area
usually receive SDC2, ADHFE1, and PPP2R5C gene methylation testing as the CRC screening
program? If so, the cross-sectional design is reasonable because data can be retrospectively
collected. Please explain whether the residents in Otokqianqi area can receive other screening
methods, including FIT. In contrast, if SDC2, ADHFE1, and PPP2R5C gene methylation testing
was performed only for this study, the study design must be a prospective study. The explanation
about informed consent evokes that this study was conducted in a prospective manner. Please
specify the details of the study design in the Method section.
3. Patients with inflammatory bowel diseases and familial polyposis should be excluded. Please
specify the information about this.
4. If this study was a cross-sectional study, the data were retrospectively collected. It does not
make sense to calculate a sample size.
5. Please discuss the cost-effectiveness of the multi-DNA screening used in this study because
this method seems to be more expensive than FIT and single DNA methylation testing.
Minor points
1. In the Abstract, the description regarding the number of enrolled individuals and their age
should be moved to the Results section.
2. SDC2, ADHFE1, and PPP2R5C gene methylation testing are not common in most areas
outside China. Please bliefly explain the methodology of this testing in the Abstract.
3. In the Abstract, the first sentence in the Result section noted “using fecal SDC2 gene
methylation test.” Is this a typo for “SDC2, ADHFE1, and PPP2R5C gene methylation test”?
4. Please use “advanced adenoma” instead of “progressive adenoma.”
5. In the Introduction, the second sentence needs appropriate citations.
6. The 3rd sentence in the Introduction: is this correct? The stages of CRC at identification
depend on the cohort. Most CRC cases found in the screening cohort must be early-stage cancers.
In contrast, CRC cases found based on the symptom frequently show advanced phenotypes.
7. The introduction is too long. Unexpectedly, the aim of this study is not depicted in the
Introduction.
8. Chi-squared values were not necessary to describe.
Title: Analysis of the effect of fecal SDC2, ADHFE1 and PPP2R5C gene methylation test for
screening colorectal cancer in the Otog Front Banner
Version: 0 Date: 14 Nov 2024
Reviewer's report:
Thank you for the opportunity to review the manuscript entitled “Analysis of the effect of fecal
SDC2, ADHFE1 and PPP2R5C gene methylation test for screening colorectal cancer in the
Otokqianqi area”. The aim of this study is clinically important. However, there are several
questions.
Major points
1. This study did not compare the efficacy of SDC2, ADHFE1, and PPP2R5C gene methylation
testing to another method, such as FIT. Thus, the results do not support the conclusion “SDC2,
ADHFE1, and PPP2R5C gene methylation testing can effectively detect CRC.” A comparison
with another method is mandatory to determine its efficacy. Please revise the conclusion
appropriately.
2. The reviewer could not understand the study design. Do all individuals in Otokqianqi area
usually receive SDC2, ADHFE1, and PPP2R5C gene methylation testing as the CRC screening
program? If so, the cross-sectional design is reasonable because data can be retrospectively
collected. Please explain whether the residents in Otokqianqi area can receive other screening
methods, including FIT. In contrast, if SDC2, ADHFE1, and PPP2R5C gene methylation testing
was performed only for this study, the study design must be a prospective study. The explanation
about informed consent evokes that this study was conducted in a prospective manner. Please
specify the details of the study design in the Method section.
3. Patients with inflammatory bowel diseases and familial polyposis should be excluded. Please
specify the information about this.
4. If this study was a cross-sectional study, the data were retrospectively collected. It does not
make sense to calculate a sample size.
5. Please discuss the cost-effectiveness of the multi-DNA screening used in this study because
this method seems to be more expensive than FIT and single DNA methylation testing.
Minor points
1. In the Abstract, the description regarding the number of enrolled individuals and their age
should be moved to the Results section.
2. SDC2, ADHFE1, and PPP2R5C gene methylation testing are not common in most areas
outside China. Please bliefly explain the methodology of this testing in the Abstract.
3. In the Abstract, the first sentence in the Result section noted “using fecal SDC2 gene
methylation test.” Is this a typo for “SDC2, ADHFE1, and PPP2R5C gene methylation test”?
4. Please use “advanced adenoma” instead of “progressive adenoma.”
5. In the Introduction, the second sentence needs appropriate citations.
6. The 3rd sentence in the Introduction: is this correct? The stages of CRC at identification
depend on the cohort. Most CRC cases found in the screening cohort must be early-stage cancers.
In contrast, CRC cases found based on the symptom frequently show advanced phenotypes.
7. The introduction is too long. Unexpectedly, the aim of this study is not depicted in the
Introduction.
8. Chi-squared values were not necessary to describe.
Please review this paper.
user
Title: Analysis of the effect of fecal SDC2, ADHFE1 and PPP2R5C gene methylation test for
screening colorectal cancer in the Otog Front Banner
Version: 0 Date: 14 Nov 2024
Reviewer's report:
Thank you for the opportunity to review the manuscript entitled “Analysis of the effect of fecal
SDC2, ADHFE1 and PPP2R5C gene methylation test for screening colorectal cancer in the
Otokqianqi area”. The aim of this study is clinically important. However, there are several
questions.
Major points
1. This study did not compare the efficacy of SDC2, ADHFE1, and PPP2R5C gene methylation
testing to another method, such as FIT. Thus, the results do not support the conclusion “SDC2,
ADHFE1, and PPP2R5C gene methylation testing can effectively detect CRC.” A comparison
with another method is mandatory to determine its efficacy. Please revise the conclusion
appropriately.
2. The reviewer could not understand the study design. Do all individuals in Otokqianqi area
usually receive SDC2, ADHFE1, and PPP2R5C gene methylation testing as the CRC screening
program? If so, the cross-sectional design is reasonable because data can be retrospectively
collected. Please explain whether the residents in Otokqianqi area can receive other screening
methods, including FIT. In contrast, if SDC2, ADHFE1, and PPP2R5C gene methylation testing
was performed only for this study, the study design must be a prospective study. The explanation
about informed consent evokes that this study was conducted in a prospective manner. Please
specify the details of the study design in the Method section.
3. Patients with inflammatory bowel diseases and familial polyposis should be excluded. Please
specify the information about this.
4. If this study was a cross-sectional study, the data were retrospectively collected. It does not
make sense to calculate a sample size.
5. Please discuss the cost-effectiveness of the multi-DNA screening used in this study because
this method seems to be more expensive than FIT and single DNA methylation testing.
Minor points
1. In the Abstract, the description regarding the number of enrolled individuals and their age
should be moved to the Results section.
2. SDC2, ADHFE1, and PPP2R5C gene methylation testing are not common in most areas
outside China. Please bliefly explain the methodology of this testing in the Abstract.
3. In the Abstract, the first sentence in the Result section noted “using fecal SDC2 gene
methylation test.” Is this a typo for “SDC2, ADHFE1, and PPP2R5C gene methylation test”?
4. Please use “advanced adenoma” instead of “progressive adenoma.”
5. In the Introduction, the second sentence needs appropriate citations.
6. The 3rd sentence in the Introduction: is this correct? The stages of CRC at identification
depend on the cohort. Most CRC cases found in the screening cohort must be early-stage cancers.
In contrast, CRC cases found based on the symptom frequently show advanced phenotypes.
7. The introduction is too long. Unexpectedly, the aim of this study is not depicted in the
Introduction.
8. Chi-squared values were not necessary to describe.
assistant