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Medieval skeletons may hide cancer levels far higher than expected

Cancer is not just a modern disease. New archaeological analysis suggests that malignancies in medieval Britain were not as rare as we once thought.

Even before widespread smoking, the industrial revolution and the modern jump in life expectancy, cancer still seems to be the leading cause of disease.

Scanning and X-rays of 143 medieval skeletons from six cemeteries in and around Cambridge, archaeologists estimate that cancer cases between the 6th and 16th centuries are about a quarter of what they are today.

This is 10 times higher than previous predictions, in which the incidence of cancer is less than one percent.

“Until now, the most significant causes of deteriorating health in medieval humans were thought to be infectious diseases such as dysentery and bubonic plague, along with malnutrition and injuries from accidents or war,”

; said archaeologist Jenna Dietmar of the University of Cambridge.

“Now we have to add cancer as one of the main classes of diseases that affected medieval people.”

Previous analyzes of medieval skeletons in Britain have focused only on the appearance of the bone, but Dietmar and her colleagues have decided to look for evidence of bone metastases as well.

263379 webCT bone of a medieval skull with a white arrow showing metastases. (Bram Mulder)

By scanning parts of the skeleton that are more likely to retain cancer, such as the spine, pelvis and femur, the team found signs of malignancy in five individuals from the Middle Ages.

Most cases were confined to the pelvis, but there was a middle-aged man who had lesions scattered on his skeleton, indicative of blood cancer.

263378 webExcavated medieval spine, with white arrows showing cancer metastases. (Jenna Dietmar)

“Using a CT scan, we were able to see cancerous lesions hidden inside a bone that looked perfectly normal on the outside,” Dietmar said.

This type of scan can detect bone metastases in patients about 75 percent of the time, and more than a third of people who die of cancer today show evidence of these growths in their bones.

Based on these statistics, the authors estimate that the minimum prevalence of all cancers in medieval Britain would be around 9 and 14 percent.

Centuries later, this rate increased. In modern Britain, where people live far longer, breathe more pollutants and face more viruses, up to 50% of people have cancer by the time they die.

Understanding how often the incidence of cancer has increased in recent years is important because it allows us to understand where our biggest threats come from. It is not yet entirely clear how much smoking and pollutants have affected disease levels in general, as we do not have a baseline to work on.

Historical texts are not very reliable and are difficult to compare with modern data, while archaeological remains are much more reliable, especially with the technology we have today.

The sample size in the present study is obviously small and focuses on only one region. Just as difficult a business is diagnosing cancer so many centuries later.

Yet even with these warnings, the findings suggest that we have missed many cases of medieval cancer by not looking at the bone.

“We need further research using CT scans of apparently normal skeletons in different regions and time periods to see how often cancer has been in key civilizations of the past,” said the first author of the new study, archaeologist Pierce Mitchell of the University of Cambridge.

The study was published in Crab. The document is not available at the time of publication, but evidence of the press release can be viewed at Academia.edu.

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