Background: The Cochrane Collaboration promotes co-publication of Cochrane systematic reviews provided that the reviews remain free for dissemination in any and all media without restriction. Because scientific impact is not calculated for secondary publication, co-publication may become increasingly unattractive to traditional print journals.

Objectives: To describe our experiences in attempting to co-publish a Cochrane Skin Group systematic review 'Statins and Fibrates for Preventing Melanoma' in a traditional print journal, and compare these experiences with those of other Skin Group authors who have co-published.

Methods: Narrative review.

Results: After several rejections, an oncology journal's editorial board has agreed to consider the meta-analysis for co-publication provided that the inclusion criteria for the studies analyzed are altered and additional data is incorporated into the review. These experiences will be compared and contrasted with the co-publication experiences of other Skin Group authors.

Conclusions: Traditional print journals may require significant alteration of Cochrane systematic reviews for co-publication, prompting the question: At what point does a co-publication become a different study?