This is an interesting study exploring the patient’s experiences of cancer diagnosis and management of colorectal cancer. Since this is a qualitative study, and the manuscript is long, advise redrafting a few sections of the paper to make it more concise keeping only the relevant information. Some of the sections where this strategy can be applied are:-

3.1.1

3.1.3- last 3 paragraphs

3.1.4 - last paragraph 

Advise to use Table 2 as a supplemental note as there is duplication of the patient’s quotations throughout the text. 

Discussion:

The discussion section should be restructured as this section is very long and difficult to follow. Advise to categorize the codes and themes in two different categories as mentioned in the supplemental: Perceived barriers and Perceived facilitators. Under those headings advise to provide key findings of the study. For eg., the authors may choose to categorize the findings under different headings:-

Screening and diagnosis: stigma to do a colonoscopy, health care organization, health care policy, individual factors, social factors

Management: access to care, job safety, diet, physical therapy, mental health

Post-treatment: unemployment, social stigma

Provide strategies to improve the screening, diagnosis, and management of CRC in Egypt based on the findings of the study.  Some suggestions are:-

         Screening:

• Involve religious leaders and organizations to create awareness about the condition
• Involve local media or social groups to create awareness
• Involve NGOs in social awareness
• More training during medical school about the condition
• Special focus on targeting the younger population because of ‘Early onset CRC’ in this population.

          Diagnosis and management:

• Government support for cancer survivors
• Involving NGOs to help people navigate the journey of screening, access to care
• Peer support groups for those undergoing cancer treatment and post-cancer treatment.

Please see the attached PDF for further comments (marked and comments annoted).  Also, review the comments from reviewers.

It is advisable to emphasize redrafting the current manuscript to make it more concise, clear, and organized for easy readability by the audience.

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We look forward to receiving your revised manuscript.

Kind regards,

Arunima Dutta, MD, FACP, FAPCR

Academic Editor

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?

Reviewer #1: Yes

Reviewer #2: Yes

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

Reviewer #1: N/A

Reviewer #2: Yes

**********

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

The PLOS Data policy

Reviewer #1: Yes

Reviewer #2: Yes

**********

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

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: In this manuscript, the authors provide insights into the real-life experiences of CRC patients in Egypt. Results were very important to improve CRC diagnosis and treatment outcomes. Besides that, I found several concerns I described below.

-The manuscript is too long. Authors must summarize some sections and avoid repetition.

-Recruitment Period was too brief. Can authors justify this? In my opinion, the number of patient was very limited (N= 19) and this is not enough for statistical validation.

Reviewer #2: Dear authors, thank you for this intersting topic here are my comments for more clarity:

#It is bettet yo replace “Statistical Analysis” with “Data Analysis” since this is qualitative and add a brief explanation of how thematic saturation was assessed (e.g., “coding continued until no new themes emerged”).

#Table 1: please correct inconsistencies (e.g., text says “12 males, 7 females” but Table 1 says “17 males”; age mean in text is 53.4 but Table 1 says 54.8). Standardize BMI categories (e.g., “Optimum range” could be “Normal” per WHO).

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Reviewer #1: No

Reviewer #2: No

**********

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Attachments

Attachment

Submitted filename: PONE-D-25-14121_suggestions.pdf

Mapping the Colorectal Cancer Patient Journey in Egypt: A Qualitative Study of Diagnosis, Treatment, and Lifestyle Perspectives

PONE-D-25-14121R1

Dear Dr. Bassiony,

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,

Arunima Dutta, MD, FACP, FAPCR

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

The revised manuscript is concise and well-structured. It provides a clear description of the different barriers and facilitators for colorectal cancer screening and management in Egypt.

Reviewers' comments: