Italy (9.8%) is runner-up in the international paper chase, followed by the United Kingdom (8.5 per cent), Japan (6.9 per cent) and France (6.3 per cent). The results were reported today (Tuesday 23 October) at ECCO 11 - the European Cancer Conference in Lisbon.
Dr. Francesco Grossi, of the University of Udine said: "Overall, the results were as we expected. We expected the USA, UK, Japan and France in the top spots. We were pleasantly surprised by Italy".
The initial impetus of the study was to establish Italy's standing in clinical cancer research. Dr. Grossi explained: "We then decided to perform a bibliometric analysis on our own. Doing that, we realised the huge amount of information we were collecting".
He and his colleagues also examined the so called "impact factor" (IF) of the 3,142 papers in the survey. The IF, a reflection of the scientific importance of an individual paper, measures the number of times after publication it is quoted or cited by other journals. The mean IF of the North American papers in the survey was found to be higher than that of the European ones (3.54 v 3.14).
The study was restricted to clinical oncology papers reporting phase I, phase II and phase III studies* and published in the years 1995-1999. A total of 3,247 such papers were identified, but the researchers restricted the survey to 25 countries with at least ten studies meeting the restriction criteria.
Dr. Francesco Grossi, of the University of Udine said: "Interestingly, the majority of phase one studies were published in North America, while most of the phase III studies were performed in Europe. EORTC (European Organization for Research and Treatment of Cancer) is the most active co-operative group".
"The differences may be explained by the fact that the US is currently the richest reservoir of biomedicine and biotechnology in the world. New compounds and new molecules coming out from the numerous US biopharmaceutical companies are first tested in US (phase I) trials".
The number of papers in the study may seem large, but they represent only a small proportion of the total number published each year. Some two million papers and articles a year are estimated to be of importance to medical practice. It is estimated that, on average, health professionals should be reading 19 medical and scientific articles a day to keep up to date. It is this pressure which has led to the mass of clinical guidelines which characterize modern medical practice.
Why are there so many papers? There have been advances in scientific medicine in the last 50 years than in the previous 2000. This has not only been the driving force behind the therapeutic revolution, but also of the explosive growth in medical publishing. The foundations for this growth were laid in 1879 with the launch of Index Medicus, the first printed biomedical bibliography. But the kind of information gathering previous generations associated with the musty scent of ageing paper has now been eclipsed by Internet searches and the clicks, beeps and whirrs of the computer.
Grossi 2
Why did Italy fare well? There is some evidence that countries with a lot of physicians (as Italy has) tend to produce more papers than countries with fewer numbers of doctors. Dr. Grossi said: "Although the number of physicians involved in clinical research is nearly impossible to obtain due to the multidisciplinary nature of this field, it is a fact that Italy has significantly more physicians than many other developed countries. Thus, it is likely that Italy's performance may be a reflection of the number of physicians involved in cancer treatment".
*Notes Once permission has been given to test compounds in people, they go through three test phases: - Phase I trials look fundamentally at safety, progressing to increasing numbers of patients if the compound shows promise. For every 100 medicines tested, only 70 get through the phase one hurdle.
Phase II trials are designed to investigate safety and efficacy. Phase two trials may take two years or more and have a high attrition rate. Only a third of medicines tested reach phase 111 testing.
Phase III trials are designed to test safety and efficacy in large numbers of patients and typically takes up to three years or more.
NB: The abstract (No: 854) relating to this presentation contains preliminary figures. This press release includes the up to date figures.
Top 10 Countries ranked by number of papers published in 1995-1999
| Country | Number of Total Papers 1995-1999 |
Share of Papers 1995-1999 |
By year | By Phase | ||||||
| 1995 | 1996 | 1997 | 1998 | 1999 | I | II | III | |||
| USA | 1186 | 37.75 | 240 | 199 | 244 | 257 | 246 | 470 | 520 | 196 |
| Italy | 308 | 9.80 | 52 | 72 | 62 | 60 | 62 | 65 | 145 | 98 |
| UK | 267 | 8.50 | 58 | 52 | 61 | 63 | 33 | 72 | 71 | 124 |
| Japan | 217 | 6.91 | 34 | 39 | 40 | 44 | 60 | 43 | 95 | 79 |
| France | 197 | 6.27 | 36 | 51 | 33 | 37 | 40 | 45 | 84 | 68 |
| Germany | 164 | 5.22 | 22 | 33 | 36 | 41 | 32 | 47 | 69 | 48 |
| Netherlands | 120 | 3.82 | 20 | 25 | 24 | 27 | 24 | 37 | 47 | 36 |
| Canada | 102 | 3.25 | 21 | 24 | 12 | 25 | 20 | 32 | 37 | 33 |
| Spain | 68 | 2.16 | 12 | 11 | 12 | 17 | 16 | 6 | 33 | 39 |
| Greece | 57 | 1.81 | 4 | 13 | 12 | 15 | 13 | 3 | 32 | 22 |
Further information: Maria Maneiro +351 21 892 1818 (till 25 October) +32 2 775 02 03 (from 26 October)