Commentary
Weak campaign against predatory journals: structural issues
The International Committee of Medical Journal Editors (ICMJE) is an influential group of general medical journal editors, some from the five leading publishing houses, representing more than 50% of the market, and representatives of select related organisations. Working together to improve the quality of medical science and its reporting, they have rightly acknowledged the threat posed by predatory journals. However, we argue that ICMJE has overlooked deeper structural issues, particularly the publishing industry’s own economic interests, thus hindering efforts to address this problem. It overlooked numerous initiatives aimed at systemic change, eg, the 2012 Declaration on Research Assessment, Transparency and Openness Promotion, and the Coalition for Advancing Research Assessment. Notably, models such as Diamond Open Access, which have the potential to address the issue of predatory journals, while also posing challenges to traditional publishers’ interests, are not mentioned. By not addressing these concerns, there is a risk that the ICMJE's crusade against predatory journals could look like cartelisation.
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Excellent article. But I wonder why the authors noted, quoting two US studies, that about 1 in 7 cases of screen-detected cancer is over-diagnosed when the true number is much higher. In our systematic review of different countries, we found that 1 in 3 women invited to screening are overdiagnosed (1), and our data from Denmark, which are unique, as there was only screening in 20% of the country for 17 years, showed 1 in 4 (2). Since not all women who are invited turn up, the level of overdiagnosis detected at screening would be even higher.
The authors write that the term “overdiagnosis” was absent in the 55-page review (with 494 references) from the Lancet Breast Cancer Commission, while the word “screening” appeared 55 times.
When I updated our Cochrane review of mammography screening with my co-author with more deaths in 2025, Cochrane rejected it. Among other things they refused to let us call overdiagnosis overdiagnosis, which we had done in earlier versions of our review (3). This is yet another huge Cochrane scandal. In 2001, when we published our review for the first time, Cochrane refused to allow us to include data on overdiagnosis even though such data appeared in the protocol for the review, which the Cochrane Breast Cancer Group in Australia had themselves approved and published. It took five years of repeated complaints to Cochrane leaders before I was allowed to include the data.
1 Jørgensen KJ, Gøtzsche PC. Overdiagnosis in publicly organised mammography screening programmes: systematic review of incidence trends. BMJ 2009;339:b2587.
2 Jørgensen KJ, Zahl PH, Gøtzsche PC. Overdiagnosis in organised mammography screening in Denmark: a comparative study. BMC Womens Health 2009;9:36.
3 Gøtzsche PC. Cochrane on a suicide mission. Brownstone Journal 2025;June 20.