An Italian newspaper has found duplicated images in eight cancer papers co-authored by the country’s minister of health, Orazio Schillaci. Schillaci, a physician with a Ph.D. in nuclear medicine, published the papers between 2018 and 2022 while working in the faculty of medicine of the University of Rome Tor Vergata.

The duplications, reported today by Il Manifesto, include cases in which the same image is presented as showing cells from different tissues or cancers and images supposedly representing cells from different patients that are in reality the same image with a change of scale. Science has confirmed the evidence with image integrity experts.

Schillaci did not respond to a request for comment. But at a public event this morning, he shrugged off the reports. “I am not worried. I have not manipulated anything,” he said. “The images do not come from my laboratory, but from other colleagues that have not done anything wrong.”

Image integrity experts say there’s no doubt about the duplications, though whether they were intentional is unclear. “It may be sloppiness in keeping track of each picture, or intentionality, because the pictures always fit the narrative [of the paper],” says Elisabeth Bik, a science integrity consultant. “In any case, this casts doubts on the accuracy of other experimental findings of this lab.”

Schillaci joined Tor Vergata in 2001, becoming dean of the faculty of medicine in 2013 and rector of the university in 2019. He is a prolific author, with more than 400 papers registered in Scopus, a database of scientific literature. During the years in which the papers with duplications were published, he produced papers at a rate of one every 12 days; he has continued to publish since becoming health minister for Italy’s far–right-wing government in 2022.

These prolific publishing rates drew the attention of Il Manifesto, a left-wing newspaper, which decided to check the quality of the minister’s work. In its investigation, the paper used software called ImageTwin to detect any evidence of picture duplication within a sample of papers co-authored by Schillaci

Another paper, published in 2019 in the International Journal of Molecular Sciences, looked at the development in breast cancer of cells that produce calcium deposits, like bone cells. A picture of these breast tissue cells in that paper is identical to one of actual bone cells in a different paper, published in 2018 by one of Schillaci’s co-authors, on the effect of microgravity on bones.

In some cases, images are duplicated within a single paper. For instance, in a 2018 paper, published in Contrast Media & Molecular Imaging, a picture of prostate cancer cells is labeled as coming from a patient with bone metastasis, and is then displayed again at a different scale and labeled as coming from a nonmetastatic patient.

Both Bik and Jennifer Byrne, professor of molecular oncology at the University of Sydney, say the duplications are not the result of legitimate experimental procedures.

The duplications may well be inadvertent, says Mike Rossner, president of the Image Data Integrity consultancy. “It is possible that the author just grabbed the wrong file when preparing that figure panel,” he says. But even if they are simple errors, Byrne says, “When one group seems to be making such errors repeatedly, this could indicate that their data-handling processes may have been flawed.”

Given that so many papers are affected, the university should investigate, Bik says. “You absolutely need an independent panel,” agrees Daniele Fanelli, an expert in research integrity at the London School of Economics and Political Science. “What ought to happen in any reputable scientific institution is that an independent committee without conflicts of interest [should] investigate and then issue corrections, or sanctions if necessary.” Tor Vergata did not respond to a request for comment.

It remains unclear who added the duplicated images. Schillaci is listed as corresponding author on four of the papers under scrutiny, but three other researchers at Tor Vergata also appear on all eight publications. And according to declarations made in the papers, Schillaci’s contribution varied from coming up with the idea for the work, to correcting and reviewing it, to doing the research and writing.

Still, the duplications raise the question of whether being a rector—or a cabinet minister—is compatible with highly productive experimental activity. It’s the question the scientific community has been grappling with since the president of Stanford University, Marc Tessier-Lavigne, announced his resignation in July following an investigation into practices in his laboratory. “You cannot do two jobs and do them both well,” Bik says.