The Implementation of a Primary HPV Self-Testing Cervical Screening Program in Malaysia through Program ROSE—Lessons Learnt and Moving Forward

Round 1

Reviewer 1 Report

In the manuscript titled 'The implementation of a primary HPV self-testing cervical screening program in Malaysia through Program ROSE – Lessons learnt and moving forward' the authors described a comprehensive program implemented in Malaysia for screening of HPV in women. The mini-review explained the Malaysian landscape in terms of infrastructure and cervical screening in Malaysia along with the evolution of the ROSE program and its goals relevant to the aforementioned attributes of Malaysia. The manuscript is important in terms of putting the efforts of the program and its landmarks to the forefront, therefore can be recommended for publication in the special issue of Current Oncology provided the language errors are rectified by the authors.

Critique: 

There are minor language errors in the manuscript.

Author Response

Thank you for your comment.

The manuscript has been reviewed by all authors and the language errors have been rectified.

Reviewer 2 Report

Important report. Please review grammer/syntax e.g. L39, L73, L107, L123, L176, L219, L236

A few minor comments:

L29: please add time of achieving the targets (2030)

L152: italics

L190: I suggest to rephrase as pilot studies are small be design, phase 3 (pharmaceutical studies)  are also large

L199-205: argument not clear

L217: time to achieve global elimination is predicted for 2100 (https://doi.org/10.1016/j.pvr.2019.100170)

L254-256: which cadre helped to allay fear of obtaining HPV result (non-medically trained personnel or program staff)?

L288: please provide reference

L296: as L217

Author Response

List of comments/suggestions and responses

The reviewer’s comments/suggestions are in bold and our responses in regular text.  Any additions made to the text in the manuscript have been underlined. 

Important report. Please review grammer/syntax e.g. L39, L73, L107, L123, L176, L219, L236

The manuscript has been reviewed by all authors. All the language errors have been rectified by a native speaker, including those mentioned above.

A few minor comments:

L29: please add time of achieving the targets (2030)

Thank you. Edit has been made at Line 32-34.

“It is estimated that the rapid scale-up of these interventions would result in most countries achieving the elimination goal of new cases of cervical cancer at less than 4 per 100,000 women by 2100 [3].”

L152: italics

The subtitle has been formatted.

L190: I suggest to rephrase as pilot studies are small be design, phase 3 (pharmaceutical studies)  are also large

This sentence has been removed.

L199-205: argument not clear

The paragraph (Line 199-203) has been restructured to improve clarity.

“The experts from our partner laboratory also provided subsequent technical support in relation to HPV testing. For instance, when approached by different manufacturers or their distributors with potentially new products, the team at ROSE have rapid access to experts for an independent and evidence-based perspective.”

L217: time to achieve global elimination is predicted for 2100 (https://doi.org/10.1016/j.pvr.2019.100170)

Thank you for the suggestion. Edits have been made at Line 212-215, as shown below:  

“With the discovery that high-risk HPV is the necessary cause of cervical cancer [39], the scientific community consolidated their knowledge to develop effective vaccines and screening tools within a relatively short time, enabling the realization of eliminating a human cancer within the century [3].”

L254-256: which cadre helped to allay fear of obtaining HPV result (non-medically trained personnel or program staff)?

The program staff, whom most are non-medically trained, helped to allay fear of obtaining HPV result. Edits have been made at Line 250-252, as shown below:

“This process is facilitated by a simplified algorithm that allows program staff, most of whom are non-medically trained, to engage with women, linking them to the nearest treatment center.”

L288: please provide reference

Thank you. The reference has been added.

L296: as L217

Thank you. Edits have been made at Line 291-293 as shown below:

“Together with Malaysia’s longstanding and highly successful HPV vaccination program, perhaps Malaysia could be the first country in the region to reach the cervical cancer elimination target (4 per 100,000) by 2100 [3].”