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This new study highlights that the rate of medieval cancer was higher than previously believed. This image shows an excavated spine bone with signs of cancer metastases, signaled with the white arrow. (Jenna Dittmar)
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SCIENCE & TECH:
Medieval Cancer Rates Were Shockingly High, New Study Shows

A team of University of Cambridge researchers have just released the results of their study of cancer incidence in medieval and pre-Industrial Revolution-era Britain. The scientists examined the remains of 143 men and women, retrieved from six ancient cemeteries in and around Cambridge, to look for evidence of cancer. Based on their discoveries and statistical projections, they were able to determine that medieval cancer rates were much higher than was previously believed.

According to the findings of the Cambridge research team, medieval cancer rates were up to 10 times higher than expected. Previous studies had concluded that less than one percent of medieval British residents had suffered from cancer at the time they passed away. But this new research showed that the real number was more likely in the 9 to 14 percent range. In other words, a ten-fold increase in what had been hypothesized before. These eye-opening results have now been published in the peer-reviewed medical journal Cancer.

Biological Excavations Reveal Medieval Cancer Truths

To search for signs of potentially fatal cancer in medieval times, the Cambridge researchers took X-rays and CT scans of the skeletal remains of 96 men, 46 women, and one person of undetermined sex who had lived, died, and been buried in Cambridge-area cemeteries between the sixth and 16 th centuries AD. The researchers focused on bone samples taken from the femur, pelvis, and spine, areas most likely to be affected by cancers that spread from soft tissues or organs into the bones.

Among this group of 143 individuals, five showed signs of interior bone damage caused by cancer. This means 3.5 percent of the men and women in the sample population were suffering from serious forms of cancer at the times of their deaths, with the cancer presumably contributing heavily to those casualties. All of the individuals who’d had cancer had been middle aged or older when they met their demise.

Past studies have only looked for exterior lesions on recovered bones. This explains why their estimates of medieval cancer rates were so low in comparison to these new findings. “Only some cancer spreads to bone, and of these only a few are visible on its surface, so we searched within the bone for signs of malignancy,” explained the study’s lead researcher, Dr. Piers Mitchell , who is the Director of the Ancient Parasites Laboratory in the University of Cambridge Department of Archaeology.

This new study highlights that the rate of medieval cancer was higher than previously believed. This image shows an excavated spine bone with signs of cancer metastases, signaled with the white arrow. (Jenna Dittmar)

Using Modern Cancer Research to Make Statistical Projections

Making logical statistical projections from the available data, the researchers calculated that somewhere between nine and 14 percent of medieval British residents would have been suffering from cancer at the time of their deaths. “Modern research shows a third to a half of people with soft tissue cancers will find the tumor spreads to their bones,” highlighted Mitchell. “We combined this data with evidence of bone metastasis from our study to estimate cancer rates for medieval Britain.”

The men and women whose bones were exhumed and examined comprised a diverse cross section of people representing all walks of life and living conditions. “We had remains from poor people living inside town, we had the rich people living inside town, we had an Augustinian friary inside town and we had a hospital, so we had a real mixture of the different kind of subpopulations that you get in medieval life,” Dr. Mitchell said. He confirmed the bone sample population also included individuals who farmed and resided in rural areas.

Mitchell hopes this project will serve as a template for future surveys. “We need further studies using CT scanning of apparently normal skeletons in different regions and time periods, to see how common cancer was in key civilizations of the past,” he stressed.

As part of their study of medieval cancer, this CT scan of a skull bone shows the metastasis hidden within. (Bram Mulder)

As part of their study of medieval cancer, this CT scan of a skull bone shows the metastasis hidden within. (Bram Mulder)

Could Medieval Cancer Rates Have Been Even Higher?

Despite its pioneering incorporation of advanced imaging technology, the Cambridge study does have some limitations. For one thing, the sample size was relatively small, especially considering the vast chronological expanse – 1,000 years – that the study attempted to cover. A larger sample size might have revealed cancer rates that were somewhat higher or lower overall, and it would have allowed the researchers to distinguish between rates in different centuries.

Additionally, the bones retrieved all came from the same small geographical area, where cancer rates might have been higher or lower than in other locations inside or outside of Britain. Another issue is the sensitivity of X-rays and CT scans. It’s possible they might have missed signs of bone cancer in some individuals if they were still in the nascent stage. In a few instances, the researchers found indications of damage that they couldn’t definitively link to cancer, although the disease could conceivably have been the cause.

There may also have been a bias in the distribution of the samples. It is possible that bones riddled with cancer would be less likely to survive the passage of time when buried underground, meaning the sample could have been overrepresented with bones that contained no cancerous remnants. Another possible distortion is that cancer in some instances could have spread to other bones besides those of the femur, spine, and pelvis, which are the most common but not exclusive outlets for bone-related metastasis. All of this implies is that cancer rates in medieval times could have been even higher than the new research suggests.

Cancer as a Timeless Risk to Human Health

“Until now, it was thought that the most significant causes of ill health in medieval people were infectious diseases such as dysentery and bubonic plague, along with malnutrition and injuries due to accidents or warfare,” declared study co-author Jenna Dittmar, an associate researcher at Cambridge’s McDonald Institute for Archaeological Research, in CNN health . “We now have to add cancer as one of the major classes of disease that afflicted medieval people.”

Nevertheless, cancer rates in the modern world are still much higher. In the United Kingdom today, between 40 and 50 percent of people will have cancer in their bodies at the time they die. This greatly increased risk has been linked to unhealthy lifestyle choices such as smoking and poor dietary habits, as well as high levels of exposure to chemical pollutants introduced into the environment through various industrial and agricultural practices and the burning of fossil fuels.

Despite these factors, it turns out that cancer has always been with us, even before the Industrial Revolution dramatically changed the way people worked and lived. This study “really does highlight that cancer wasn’t this really rare disease in the past that most people think of it as being,” concluded Mitchell in The Guardian . It seems that cancer is a chronic and pervasive risk to human health, and that factors that could trigger its development have been present in relative abundance throughout history. All the more reason to invest in understanding the history of cancer and its possible cures.

Top image: The image shows the human remains unearthed at the former Hospital of St. John the Evangelist in Cambridge, as part of a study on medieval cancer rates. Source: Cambridge Archaeological Unit / St John’s College

By Nathan Falde

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SCIENCE & TECH: Medieval Cancer Rates Were Shockingly High, New Study Shows

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