"Results. The model achieved an accuracy of 0.91. When applied to the cancer research literature, it flagged 261 245 of 2 647 471 papers (9.87%, 95% confidence interval 9.83 to 9.90) and revealed a large increase in flagged papers from 1999 to 2024, both across the entire corpus and in the top 10% of journals by impact factor. More than 170 000 papers affiliated with Chinese institutions were flagged, accounting for 36% of Chinese cancer research articles. Most publishers had published substantial numbers of flagged papers. Flagged papers were overrepresented in fundamental research and in gastric, bone, and liver cancer."