The Evolution of Medical Journals: Why “Oncology”?

Had Charles Darwin lived in the late 20th century, he might have found amusement in contemplating the evolution of biomedical journals. Often arising by a kind of mutation from preexistsing ones, a new journal may take over an ecological niche if it exhibits certain selective advantages over the competition. The most important of these, of course, is the quality of its contents, which determines its “reproductive advantage,” i.e., the number of consistent readers and the enthusiasm of advertisers.

According to this admittedly strained analogy, one might expect that journals would have to adapt to changes in their environment or risk extinction. In reality, though, the birth-and-death process for journals is dominated by births, as a casual stroll through any medical library will confirm. Few seem to go under, even when their contents richly merit a quick coup de grace. The proliferation of medical journals is a bit reminiscent of the growth and diversity of the millions of insect species: one admires their hardiness even while reaching for the DDT. In fact, at the most recent meeting of the National Cancer Advisory Board, Dr. David Korn called for a euthanasia program for medical journals.

So why ONCOLOGY? In brief, it seemed to us that, despite the proliferation of cancer journals, a few important ecological niches remained unfilled. Specifically, the field still lacks a widely distributed vehicle that focuses on the practical management of patients with neoplastic disease across the whole spectrum of relevant subspecialties. Such a publication would have broad relevance to the problems faced daily by practicing oncologists. In addition, since many issues in contemporary cancer management are complex and controversial, a new journal with this focus should attempt to deal directly with the controversies that make medical decision-making so challenging. A recent survey among practicing oncologists revealed considerable enthusiasm for a new publication of this kind.

ONCOLOGY will be supported largely by advertising revenues and will be sent without charge monthly to about 14,000 professionals in the US, including all medical, surgical, radiation, pediatric, and gynecological oncologists, hematologists, physicians who have declared a secondary subspecialty in any of these areas, and many nurse oncologists.

The contents of ONCOLOGY will fall into two basic categories. The core will consist of solicited articles surveying a particular topic of current practical importance in clinical cancer. These topics may either be very broad or quite narrow. From time to time we shall also include subjects relating to early development issues if they are of particularly high interest or likely to have clinical implications within a reasonable period of time. Upon submission, each paper will be referred to two reviewers, who will be asked to write a short commentary to appear longside the paper. The commentary might be entirely laudatory, highly critical, or something in between. In any case, it should serve to highlight areas of consensus or disagreement among people most familiar with the topic. The result ought to be both lively and informative.

We will also publish unsolicited manuscripts that describe original observations or results of research studies or trials having clinical relevance. These papers will be peer-reviewed in a fashion similar to that used by most existing medical journals. As with the solicited manuscripts, we shall insist that the submitted papers be relevant to medical practice. In general, we do not want ONCOLOGY to become a forum for the presentation of early developmental work, for which many suitable journals already exist. Rather we prefer to focus on clinical papers having direct relevance to the practicing clinician.

A publication of this format and distribution seems an ideal way to communicate comprehensive and up-to-date information on clinical cancer to the oncology community. We would welcome the thoughts of the readership on how ONCOLOGY might be made most responsive to current needs.