JCO's AI Policy: ASCO Rules for the Top Clinical Oncology Journal

ASCO's AI policy applies across all ASCO journals:

JCO Clinical Cancer Informatics is particularly relevant, it's the ASCO journal that publishes AI research in oncology. The distinction between research AI (your cancer detection model) and writing AI (ChatGPT editing your manuscript) applies here just as it does at Nature Biotechnology or Nature Methods.

JCO papers directly influence clinical practice. Disclosures should be specific about what AI touched and, critically, what it didn't touch.

For a clinical trial report:

"During the preparation of this manuscript, the authors used ChatGPT (GPT-4, OpenAI) to improve the clarity of the Introduction and Discussion sections. No AI tools were used for the statistical analysis (performed by the trial biostatistician, K.L., using SAS 9.4), interpretation of clinical outcomes, assessment of adverse events, or formulation of treatment recommendations. All AI-edited text was reviewed by the principal investigator (A.B.) and the study chair (C.D.) for accuracy against the trial database. The authors take full responsibility for the published content."

For a translational oncology paper:

"The authors used Claude (Claude 3.5, Anthropic) to edit the Methods section for language clarity. GitHub Copilot (Microsoft) assisted with writing R scripts for the RNA-seq analysis of tumor samples. All code was validated against TCGA reference datasets. No AI tools were used for clinical interpretation or patient outcome analysis. The authors take full responsibility for the content."

For a review or clinical practice guideline update:

"During preparation of this manuscript, ChatGPT (GPT-4, OpenAI) was used to improve the readability of the background sections. The clinical recommendations, evidence assessment, and grading of evidence quality are entirely the work of the expert panel. All AI-suggested text was reviewed by the panel chair (E.F.) and the methodologist (G.H.)."

Why the negative disclosure matters at JCO

Notice that each example explicitly states what the AI didn't do. At a basic science journal, this level of detail might be unnecessary. At JCO, it's expected because:

• Oncologists reading the paper need to know the clinical conclusions are human-generated
• Regulatory agencies may review JCO papers that support drug approvals
• Practice guidelines committees rely on JCO trial reports as primary evidence
• Insurance companies reference JCO publications for coverage decisions

A JCO reader who sees "AI assisted with manuscript preparation" wants to know: did it touch the survival analysis? The response rates? The adverse event tables? The recommended dosing? Answering "no" to these questions in your disclosure builds trust.

JCO's enforcement carries clinical-weight consequences:

During review:

• Editor contacts corresponding author
• Clinical reviewers may flag AI-generated language patterns
• Disclosure must be added
• If AI involvement in clinical content is suspected, the trial's data integrity may be questioned

After publication:

• Correction for minor language editing non-disclosure
• Expression of concern for unclear scope, especially if clinical content was affected
• Retraction for fabricated data or AI-generated clinical claims

The regulatory dimension: JCO trial reports are frequently cited in FDA submissions, EMA applications, and NICE evaluations. If a JCO paper is corrected or retracted for undisclosed AI use in clinical content, this can:

• Trigger regulatory agency review of the underlying trial data
• Cause the trial sponsor to issue a communication to investigators
• Affect the drug's regulatory status if the paper was a key registration study
• Lead to insurance coverage reassessments

ASCO professional consequences: ASCO membership includes most practicing oncologists in the US. An ethics investigation by JCO can affect your ASCO membership status, eligibility for ASCO committees, and ability to present at the ASCO Annual Meeting, the world's largest oncology conference.

JCO and Lancet Oncology are the two journals with the highest direct impact on clinical practice. Both have AI policies that reflect this clinical responsibility. JAMA Oncology (AMA) follows the more prescriptive JAMA Network approach requiring tool name, version, and manufacturer.

Cancer Discovery (AACR) publishes more translational and basic science oncology, where the clinical stakes of AI disclosure are somewhat lower. But the same fundamental rules apply.

For clinical trial reports:

• Never use AI to interpret clinical outcomes, response rates, or survival data
• Don't use AI to draft the adverse events section, this must reflect the actual safety database
• If AI helped with language, be explicit about which sections and confirm clinical content wasn't touched
• Have the trial biostatistician verify that AI didn't influence any analysis code

For practice-relevant papers:

• If your paper includes treatment recommendations, write these yourself. AI-generated treatment advice in JCO would be a serious integrity issue.
• Disclose AI use in the cover letter as well as Methods, JCO editors appreciate the transparency

For biomarker and translational papers:

• AI can help with bioinformatics code, but validate against established pipelines
• Don't use AI to generate hypotheses about biomarker-treatment interactions in the Discussion
• Patient-level genomic data shouldn't be processed through cloud AI tools

Before submission checklist:

• [ ] AI disclosure in Methods section
• [ ] Explicit statement about what AI didn't touch (clinical data, outcomes, recommendations)
• [ ] Tool name, version, and use case specified
• [ ] No AI-generated images
• [ ] Statistical code validated by biostatistician
• [ ] No patient data processed through cloud AI
• [ ] All co-authors (including trial collaborators) aware of AI disclosure
• [ ] Trial sponsor informed of AI use if applicable

A free manuscript assessment can help verify your JCO submission meets ASCO's requirements before submission.