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Medical Journal Casts Doubt on Oral Cancer Research
by: E.J. Mundell

The New England Journal of Medicine is raising another warning flag over published research by a Norwegian cancer specialist who apparently fabricated his data for another medical journal. The editors of NEJM, in an unusual "Express of Concern" editorial released late Friday, contend that Dr. Jon Sudbo of the Norwegian Radium Hospital in Oslo may have doctored a photograph to represent different stages of his oral cancer research for findings that were published by the journal in 2001. And since the same people and database from the 2001 study were used for another study published in the journal in 2004 on a new biopsy technique for oral cancer, the NEJM editors are now questioning that study's validity as well. Sudbo has reportedly admitted he faked patient data for an oral cancer study published in October in The Lancet. That study contended that long-term use of certain non-steroidal anti-inflammatory drugs reduced the risk of oral cancer. The Norwegian daily newspaper Dagbladet has reported that 250 of Sudbo's sample of 908 people in that study all shared the same birthday. The editors of The Lancet issued their own "Expression of Concern" in the Jan. 21 issue, saying that hospital officials had reported on Jan. 14 that Sudbo's research was "just complete fabrication." The Norwegian hospital has been examining previous research by Sudbo, including the two articles published in the NEJM. But the NEJM appears to have uncovered the problems on its own. In the editorial, Dr. Jeffrey Drazen, the editor-in-chief, and two others said that in an April 26, 2001, research article authored by Sudbo, two photographs from a microscope reportedly representing two different patients at different stages of precancerous mouth lesions were "in fact, different magnifications of the same photomicrograph." "Because the results of another study by Dr. Sudbo, published in the issue of April 1, 2004, were derived from the same subjects followed through the same database, we have similar concerns," the editorial added. "We have informed the director of Dr. Sudbo's institution ... and await the results of his investigation," the editors said. This is the second time in recent weeks that headline-making research has proven to be fraudulent. Earlier this month, the journal Science announced it was retracting two papers by South Korean stem cell researcher Hwang Woo-suk, who acknowledged false data that claimed to show he created stem cells from the world's first cloned human embryos. For the 2004 oral cancer study in the NEJM, Sudbo determined that a new biopsy technique could help oral cancer specialists determine which patients would most likely benefit from surgery. Oncologists typically recommend that all patients with leukoplakia -- pre-cancerous white patches on the tongue or mouth -- have surgery to remove the suspicious area if a biopsy shows pre-cancerous cell changes called dysplasia. But Sudbo's research, involving data on the treatment and long-term survival of 150 patients diagnosed with pre-cancerous oral leukoplakia, showed that those who eventually died from the disease had tested positive on the biopsy for a particular cellular aberration called "aneuploidy," in which cells look disordered, with an overabundance of DNA. Sudbo's finding was touted at the time as a way to shift the focus of treatment for individuals with aneuploid leukoplakias away from surgery and toward new drug therapies.

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