Reaffirming our values: the <i>Journal of the National Cancer Institute’s</i> commitment to excellence and society

With more than eight decades as a repository of the best cancer science available to clinicians, scientists, public health practitioners, and policymakers, the Journal of the National Cancer Institute—known more widely by its acronym JNCI—is recognized for its commitment to excellence. By every metric and reputational criterion, this medical journal is among the leaders in the highly competitive academic publishing space for oncology and cancer research. The scientific knowledge that JNCI brings to medicine and public health is central to its brand recognition. Surely, external metrics of impact keep attracting content to us, but, in retrospect, it is the attention to the quality of science, ethical principles, and scholarship that epitomize the intangible values indelibly associated with JNCI. Our readers are aware that the world of academic publishing is changing rapidly. The open access model is gradually becoming the rule rather than the exception. Launching mega-journals that emphasize the soundness of science over novelty and perceived impact has been economically successful for publishers. This has led some bad actors to take advantage of the opportunity brought by the author-pays open access model. Alternative models of peer review and preprint archiving have become popular in the industry and well received by authors. In addition, publishers of premium medical journals are increasingly leveraging their brand recognition to launch offspring specialty journals that attract submissions from authors expecting to be associated with the name of the parent journal. Many of these are oncology or cancer medicine titles. How can JNCI maintain its reputation and even enhance it at a time when values, principles, and publishing models are in such a state of flux? Our editorial vision is anchored not on the zeitgeist of the present era but on pillars that will always be structurally unassailable, such as value to our readers, scholarship, scientific validity, ethics, promotion of a life-long learning environment, and the pursuit of a socially responsible agenda of diversity, equity, and inclusion (DEI). We interpret the latter by adding geography to the core DEI constructs of gender, race, and economic means. The rationale is more than a tautological statement of being a just cause; pursuing a global oncology agenda is also a pragmatic strategy, which will diversify our content with prominent evidence on cancer control and care that is likely to influence policy where it is most needed. We should thus commit to serving much beyond the US borders. Although perception is hard to change, JNCI is an international journal. As I argue below, even our institutional roots have embraced a global health agenda. We should follow the same path. Before I describe the values that we are reaffirming for JNCI’s raison d’être, I must credit the journal’s editorial office team, deputy editors, associate editors, editors for special projects and social media, and editorial board members. Their devotion and competence I am privileged to witness daily. In addition, contributing the intellectual energy and wisdom for the new editorial vision for JNCI are many new editors in charge of implementing specific elements of that vision. I invite readers to visit the journal’s website https://academic.oup.com/jnci/pages/Editorial_Board (accessed October 19, 2023) and read the impressive credentials of these accomplished academics. As it has often been said, “it takes a village.” Although independent from the US National Cancer Institute, JNCI carries its name. Much of the reason why the journal is so prominent originates in the name association, to a time when the journal was, in fact, a knowledge dissemination outlet for scientific discoveries by intramural and extramural National Cancer Institute (NCI) scientists. Much of today’s content is of the same type, which is unsurprising because US-based authors have been represented in the masthead of 53% of JNCI papers since 2000, and the National Institutes of Health is the primary funder of cancer research in the United States. We continue to attract not only important contributions from empirical research but also value-added content, such as insightful editorials, commentaries, and cancer statistics, to inform policymaking. However, JNCI has become more international, not only in scope but also in the origin of articles. Yet, anyone reading the journal’s editorial board roster will see that NCI is the institution for many of its members, validating the name association. NCI has recently devoted much energy and resources to fostering a global oncology agenda (1,2) coherent with cancer research priorities for the country (3). This strategy is consistent with the gradual and independently driven internationalization of JNCI. The above 53% statistic implies that 47% of JNCI’s papers in 2000–2022 were authored exclusively by scientists outside of the United States, relative to 33%–44% in previous decades. It is our editorial policy to nurture our valuable association with NCI and its emphasis on global oncology. It speaks to the social responsibility of JNCI in curating valid scientific content that can be translated into evidence to improve cancer control in resource-deprived settings, whether near or afar, much beyond North America. Some of the most pressing needs, such as access to affordable care, are in the global south (4,5). There are also opportunities for unprecedented cancer control gains, such as eliminating cervical cancer, a morally necessary and attainable goal (6). JNCI should join other international medical journals as a conduit of the scientific evidence that mobilizes cancer control efforts everywhere. Being serious about implementing an international health agenda implies paying attention to where our curated content comes from. JNCI papers with authors from more than one country have become common. However, only a small fraction of our papers are exclusively from authors in low and middle-income countries (LMIC). In 1940–1959, only 0.32% were in that category. The equivalent proportions in subsequent periods were 1.91%, 1.12%, and 2.70% for 1960–1979, 1980–1999, and 2000–2022, respectively. Therefore, we are not doing as well as we should to host content from the emerging oncological science in LMICs. Another concern that should inform our editorial policies is that the papers we publish tend to come mostly from high-income countries with robust cancer research agendas. In 2022, the top five contributors (based on corresponding author affiliation) were from the US, Canada, the United Kingdom, France, and Australia. These countries were the source of 66.1% of our published content, with 42.5% from the US alone. When we examine the fraction these countries represented as sources of submitted papers, the equivalent figures were 56.4% and 44.5%, respectively. In contrast, China, an emerging academic research giant, has privileged JNCI with much cancer research content. However, Chinese authorship submissions represented 19.3% of our adjudication workload but only 2.9% of our published content in 2022. The equivalent figures for India, another country with substantial advances in science and technology, were 1.1% and 0.5%. JNCI is a general cancer sciences journal that publishes novel findings of significance in the spectrum of activities related to etiology, prevention, treatment, and survivorship. Although we welcome preclinical proof-of-concept cancer biology submissions, we are more receptive to clinical, epidemiologic, behavioral, and health outcomes research that can translate into opportunities to inform practice in cancer medicine and public health. We entertain empirical research studies, unbiased in-depth reviews, and insightful commentaries. How do we decide what we should publish? We have at our disposal the experience and knowledge of a distinguished editorial board that covers all expertise areas required to adjudicate the work we receive. We essentially ask three questions. Do the findings represent an important advance in knowledge? Are the premises and methods valid? Is the work of interest to our readers? However, these questions are not independent. Echoing Carl Sagan, “Extraordinary claims require extraordinary evidence,” which implies that our editors and reviewers must consider whether the soundness of the design, methods, and interpretation is commensurate with the gain in our understanding of a cancer-related problem. We are fortunate to host many such papers, and we celebrate their prominence by commissioning thoughtful house editorials by board members or external experts. Writing papers that communicate good science lucidly comes with experience, but not every seasoned researcher succeeds. Unsurprisingly, authors of non-Anglophone countries are at a disadvantage in addressing the above questions with convincing prose. The above statistics underscore this fact. How do we reconcile the above goals of maintaining excellence with the need to uphold the DEI principles we are committed to? To start, quality of the narrative alone is not a reason for us to turn down any paper. We commit to providing fair and unbiased assessments of manuscript submissions that fit the scope of the journal, irrespective of country of origin and other characteristics associated with inequity. We support authors using language editing services that will raise the quality of the writing to match the importance of the science communicated in the paper. We are gradually making our editorial board reflect the composition of the community we serve concerning gender, race, ethnic background, and geography. These steps help JNCI be a more equitable repository of cancer science. What concrete actions have we taken? We created a new senior editor position for DEI to translate into actions the promises we made in a recent editorial (7). We are reformulating our instructions to authors to remind them that analyses that include race and ethnicity must entertain the social constructs subsumed in these variables, thus averting the perpetual assumption that racial effects are primarily ascribed to genetic or biological differences. Likewise, promoting DEI values and social responsibility requires heightened self-awareness as a medical journal. The fact that we are focused on cancer does not preclude a larger role for us in addressing major threats to society and public health, as we did by committing with other journals to publish a major call for action regarding climate change and health (8,9). Consistent with the mission to be a valuable and unbiased vehicle for relevant cancer science generated by the research community is our commitment to an educational agenda. Foundational to our ability to adjudicate research is our opportunity to rely on committed peer reviewers, whether from our board or outside. Writing papers is hard, but so is writing insightful, constructive, and unbiased reviews. We are launching a program to assist early career investigators (ECI) to be successful as authors and reviewers. We will promote lifelong learning via mentorship arrangements. A special editor will assess all reviews and decisions for submissions by ECIs and provide more detailed information to assist them in revising the paper or reframing it for submission elsewhere. Our editorial leadership team is considering many innovative ideas to help JNCI leverage its prominence as a medical journal and its vast network of accomplished experts to serve as an educational network that promotes values of scholarship, ethics, and scientific duty. As we look outward, much beyond the US borders, to reach our goal of being a credible purveyor of the best global oncology science, we also count our blessings for the vital relationship JNCI has had with NCI. The latter is the largest cancer organization in the world by every metric. For eight decades, it has favored us to herald new clinical guidelines and divulge recommendations from consensus conferences, all content that is very relevant to our readers. We fully intend to continue deserving this privilege. We recently appointed a senior editor to serve as NCI liaison to procure such content and serve as our ambassador to the institute. This by no means implies that JNCI is emphasizing nationally generated cancer sciences to the detriment of our commitment to be international in scope. As I argued above, NCI itself has devoted much energy and resources to have an influential global health agenda. We hope to serve NCI well in promoting this agenda. In addition to insightful editorials highlighting specific articles in our content pipeline, we will bring back the popular Stat Bites series to contribute to the gestalt value of JNCI. The series was discontinued in 2017 but had a great following among our readers. Every month, it featured a graph or a visually appealing picture showing trends in cancer incidence, mortality, survival, or other clever cancer statistics of general interest. We appointed a joint team of two Features Editors to provide monthly Stat Bites highlighting North American and global content, based on reference cancer surveillance sources such as the NCI’s Surveillance, Epidemiology and End Results (SEER) program and the GLOBOCAN series maintained by the International Agency for Research on Cancer (IARC). Our goal is to expand on the scope of the original Stat Bites series by capturing visually compelling content on differences in incidence, mortality, and survival resulting from disparities in opportunities for prevention and access to care. This is consistent with our goal of addressing inequities domestically and globally. JNCI plays a central role in a family of journals maintained by Oxford University Press (OUP). We have for decades maintained JNCI Monographs, a journal that publishes thematic collections of articles of interest to our readership. In the last few years, OUP launched JNCI Cancer Spectrum as an expanded repository of knowledge that augments the reach of JNCI by publishing scientific papers that may have a subspecialty angle, report on corroborative findings, or are of a preliminary nature. Fitness to cancer sciences, validity and soundness of the scientific methods, conduct, and interpretation are the main criteria. Perception of impact should not be an obstacle to publication. Much of JNCI Cancer Spectrum’s content flows directly from JNCI as papers we transfer to it. These three journals work cooperatively as a family of respected titles under the JNCI marquee. We want a JNCI that serves our multidisciplinary community of cancer medicine. We will continue featuring guest editorials and commentaries to call attention to content that we think will be informative to our readers. Although such pieces may not be highly cited relative to the articles they showcase, they have enormous value in digesting complex empirical work to enhance our understanding of mechanisms and hypotheses at play and extracting key takeaways for busy oncologists and scientists. We want a JNCI that features new initiatives by organizations that support the academic world of cancer sciences. We will continue to publish cutting-edge science on the entire value chain of research in cancer medicine. We will procure some of that via calls for submissions on special topics. However, we will also welcome content of interest that may not fit the subjective criteria of being impactful and citable but is, in the view of our editors, material that benefits our readers. In sum, we will not be beholden to the tyranny of impact factors and similar metrics. Our influence should reflect how well we serve our community. Our authors provide the substance, and our editors, reviewers, and readers serve as sentinels to that imponderable measure called reputation. Some of the statistics reported in this editorial were based on data from the Scopus database and the journal’s 2022 submission data. Eduardo L. Franco, DrPH, PhD (Hon) (Conceptualization; Formal analysis; Writing – original draft; Writing – review & editing) No funding was used for this editorial. ELF received no funding to write this article. However, he receives funding from Oxford University Press for his role as the JNCI Editor-in-Chief, which is directly related to this work. This editorial was not peer-reviewed.

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