PONE-D-20-37144

Prevalence and Predictors of Obesity-Related Cancers Among Racial/Ethnic Groups with Metabolic Syndrome

PLOS ONE

Dear Dr. Monestime,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

An expert in the field handled your manuscript, and we are appreciative of their time and contributions. Although some interest was found in your study, several major comments arose that require your attention. Notably, there are questions about the novelty of this study and the presentation of the statistical analyses; more specifics about the patients need to be included; and the discussion section should be utilized to place the current findings into perspective of the existing literature. Please address ALL of the reviewer's comments in your revised manuscript and outline all changes in a response-to-reviewers document.

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PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: In manuscript entitled ‘Prevalence and Predictors of Obesity-Related Cancers Among Racial/Ethnic Groups with Metabolic Syndrome’ by Shanada Monestime et al., authors observe that obesity related cancers are more prevalent in Blacks and Hispanics, males and younger adults with metabolic syndrome.

I have several reservations for the study. My specific comments are appended as below:

1. Race and ethnicity is well known to be associated with the cancer aggressiveness. For instance, the death rate in African American females is 14% higher despite 7% low incidence rate (PMID: 30558195). There seems less novelty in the study reported.

2. While referring to the cardiovascular disease, authors cite relatively old reference while there are many recent evidences (PMID: 31761945, PMID: 28624099, PMID: 28421481). A careful review of cited literature is essential.

3. The authors claims that the data was obtained from 1999-2014 while the reference (reference no 13) they cite is published in 1994. This need to be explained.

4. Does authors specify past vs current individuals under medication for diabetes/hypertension?

5. While accessing the smoking status, does authors pay attention towards past/current smoker? It may not be relevant to classify a past smoker who at present does not smoke to classify in the third criteria (not at all a smoker).

6. Statistical inference should be quoted in the figures (Figure 1, 2).

7. As authors notes the observations in a range of cancer, it should be specified which cancer the obesity and metabolic syndrome related observations meet the statistical significance and what message authors like to spread through it?

8. Which cancers authors find the gender related disparity? How does authors reconcile it with hormone status?

9. As authors use only one source for the data, once the possible role of factors is identified, a careful review of literature could have conducted to justify the observations. For instance, the gender/ obesity related disparity among the observed cancers.

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Reviewer #1: Yes: Ravindra Deshpande

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Prevalence and Predictors of Obesity-Related Cancers Among Racial/Ethnic Groups with Metabolic Syndrome

PONE-D-20-37144R1

Dear Dr. Monestime,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Frank T. Spradley

Academic Editor

PLOS ONE

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Authors have now answered all my comments and manuscript in present form is much better. I approve it for publication.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Ravindra Pramod Deshpande