The European Journal of Cancer (EJC) acted inappropriately in withdrawing a paper that questioned the benefits of mammography, the authors of the study are charging. 

Peter Gøtzsche's group from the Nordic Cochrane Center in Denmark published a study in the journal in March criticizing a report on a mammography screening program in Sweden that claimed a large drop in breast cancer mortality. Gøtzsche and his colleagues wrote that the data were "flawed and incomplete" and that the incidence of breast cancer and the number of deaths were underreported. 

According to Gøtzsche, just three weeks after his article was published on the journal's Web site, it was removed. 

"I was very surprised that the paper was not only withdrawn, but completely removed...There was no trace of it," he told The Scientist

Gøtzsche laid out his concerns regarding the journal's withdrawal procedure in the November 25 issue of...

Gøtzsche believes Smyth pulled the article because of pressure from mammography proponents, in particular Peter Dean, a professor of diagnostic radiology at the University of Turku in Finland. Shortly after Gøtzsche's study was published online, Dean -- who was not involved in the Swedish mammography trials -- wrote letters to Smyth and Reed Elsevier, which owns the EJC, stating that Gøtzsche's article was based on "shoddy scholarship and serious errors in reading data in the literature" and that the paper unfairly suggests the researchers in the mammography trial skewed their results to show a benefit from the screening. "You have allowed your journal to become a platform for calumny and slander," Dean wrote to Smyth. 

"I get rather upset when people tell lies," Dean told The Scientist, "especially when it's a matter of life and death for women." 

Dean said he worked in the hospital where the trial data were collected, and that the information was carefully and consistently recorded. Gøtzsche, he believes, is being led by his own agenda against mammography screening. 

The feud between Dean and Gøtzsche is not new: In 2004 Dean published an opinion in the Journal of the American College of Radiology tearing down Gøtzsche's work. "Gøtzsche has built his own anti-screening bias into a nonscientific, personal campaign to discredit breast cancer screening, breast cancer surgery, and breast cancer oncology," he wrote. 

Others have also criticized Gøtzsche's work. In 2000, Gøtzsche and a colleague published a review of Swedish mammography trials in The Lancet that found "no reliable evidence that screening decreases breast-cancer mortality." David Freedman at the University of California, Berkeley and his colleagues analyzed Gøtzsche's work several years later and found the critique "careless at best." 

Whether Dean's letter to the EJC influenced the journal's decision to retract the paper is not clear. Smyth declined to be interviewed for this article. His assistant told The Scientist in an email that the matter may be subject to legal advice, though Gøtzsche said he has not initiated a lawsuit. Jack Cuzick, an associate editor at the journal, also declined an interview, but confirmed that he received correspondence from Dean. No one from Reed Elsevier was available for comment.

After the EJC's retraction, the Danish Medical Bulletin published Gøtzsche's article without further peer review

The publication's editor-in-chief, Torben Schroeder, included a note at the end of the article stating that he shared the authors' concerns about the manner in which the paper was withdrawn from the EJC. Schroeder told The Scientist that from an editor's point of view, "it's very worrisome that a paper is plainly removed from a Web site without further assessment, because it was peer-reviewed and accepted."

Gøtzsche stands by his analysis of the Swedish screening trials. "We believe our methods are adequate, we believe there were problems with this trial, and we believe this needs to be discussed in the open," he said. "It's terrible to suppress scientific findings." 

By Kerry Grens

Links within this article: 

European Journal of Cancer

PH Zahl et al., WITHDRAWN "Results of the Two-County trials of mammography screening are not compatible with contemporaneous official Swedish breast cancer statistics,"Eur J Cancer, March 9, 2006 (epub ahead of print).

L Tabár et al., "Reduction in mortality from breast-cancer after mass-screening with mammography," The Lancet, 8433:829-832, 1985.

Peter Gøtzsche

C. Hinestrosa, "It's Time to Improve Methods for Breast-Cancer Detection," The Scientist, April 30, 2001

PC Gøtzsche et al., "What is publication?" The Lancet 368:1854-1856.§ion=Comment

International Committee of Medical Journal Editors

L. Newman, "Developing the Ideal Breast Cancer Screening Test, The Scientist, July 9, 2001

Peter Dean

PB Dean, "Gøtzsche's quixotic anti-screening campaign: non-scientific and contrary to Cochrane principals," Journal of the American College of Radiology, 1:3-7, 2004. '

PC Gøtzsche and O Olsen, "Is screening for breast cancer with mammography justifiable?" The Lancet 355:129-134, 2000.

DA Freedman et al., "On the efficacy of screening for breast cancer," International Journal of Epidemiology 33:43-55, 2004.

PH Zahl et al., "Results of the Two-County trial of mammography screening are not compatible with contemporaneous official Swedish breast cancer statistics," Danish Medical Bulletin, 53:438-440, 2006.

A. McCook, "Is Peer Review Broken?" The Scientist, Feb. 1, 2006

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