Screening Colonoscopy Uptake Among Adult Stroke Survivors: Findings from the 2022 BRFSS Data
, Alaina Head 2, Zola Johnson 2, Wonder King Selassie Hatekah 3, Beulah Ansa 3 and Darryl Nettles 4Round 1
Reviewer 1 Report
Comments and Suggestions for Authorsplease see the attached document
Comments for author File: 
Comments.pdf
Author Response
Comments:
Comments on screening colonoscopy uptake
This manuscript pointed out that difference in race and socioeconomic state will
make the rate of screening colonoscopy different. It is an important issue for
establishment of policy for health promotion since if the screening scope could be
broadened, detection rate of colorectal cancer might be different.
The article might be accepted for publication in this edition. However, as the
detection rate of colorectal cancer showed no statistically significant difference
between patient with and without past history of stroke, these findings made screening
colonoscopy appearing to be not valuable enough. It would be better if the authors could
provide more information about what percentage of stroke is really cryptogenic? Cancer
and stroke shared similar risk factors, only in cases of stroke without obvious evil
habits and metabolic aberration, detection of colorectal cancer in these patients could
be probably attributed to correlating with cancer itself.
Response:
The authors thank the reviewer for the time and effort spent in participating in the review process of our manuscript. The comments have helped to improve the quality of the paper. We have tried to address your comment below.
The information about the percentage of cryptogenic stroke is already provided in line 56 of the manuscript: "Almost one-third of stroke patients aged 18 to 49 years have cryptogenic stroke". We also added a sentence and an additional reference in line 56: "Cryptogenic stroke accounts for 30% to 40% of ischemic stroke" (see highlighted text in yellow).
Thanks again.
Author Response File: Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for AuthorsIt is difficult to find the relationship between colonoscopy and stroke. Probably a deeper analysis could find the answer for this question.
Author Response
Comments:
It is difficult to find the relationship between colonoscopy and stroke. Probably a deeper analysis could find the answer for this question.
Response:
The authors thank the reviewer for the time and effort spent in participating in the review process of our manuscript. We have tried to address your comment below.
In our manuscript we attempted to present the relationship between colonoscopy and stroke. Our analysis revealed that stroke survivors were 1.309 times (Confidence interval (C.I.) = 1.307, 1.311; p<0.001) more likely to report having a screening colonoscopy compared to those without stroke (See lines 156-158).
Thank you again.
Author Response File: Author Response.pdf
Reviewer 3 Report
Comments and Suggestions for AuthorsIn the Introduction section, the authors describe the importance of the subject chosen and clearly state the link between stroke and colo-rectal cancer. Therefore, it increases the interest of the reader regarding the article.
The Materials and Methods section presents the design of the study, taking into consideration the ethical aspects of the study.
The results are presented in detail, using tables and figures for better understanding of them by the reader. Statistical data is also provided in this section.
After comparing the results with other studies from literature and presenting the study limitations, the conclusions are stated based on the results obtained.
Author Response
Comments
In the Introduction section, the authors describe the importance of the subject chosen and clearly state the link between stroke and colorectal cancer. Therefore, it increases the interest of the reader regarding the article.
The Materials and Methods section presents the design of the study, taking into consideration the ethical aspects of the study.
The results are presented in detail, using tables and figures for better understanding of them by the reader. Statistical data is also provided in this section.
After comparing the results with other studies from literature and presenting the study limitations, the conclusions are stated based on the results obtained.
Response:
The authors thank the reviewer for the time and effort spent in participating in the review process of our manuscript. The section-by-section evaluation of the manuscript by the reviewer is highly appreciated. The comments have helped to improve the quality of the paper.
Author Response File: Author Response.pdf
