The prevalence of cancer in Britain before industrialization

Abstract

BACKGROUND:To plan for cancer services in the future, the long view of cancer prevalence is essential. It might be suspected that cancer prevalence before tobacco and industrial revolution pollutants was quite different to today. METHODS: To quantify the degree to which cancer prevalence may be changing over time, the authors analyzed 143 skeletons from 6 cemeteries from the Cambridge area (6th-16th centuries). Visual inspection coupled with screening using both plain radiographs and computed tomography scans was used to detect malignant lesions. RESULTS: A total of 3.5% of individuals showed evidence for metastases. Factoring in modern data for the proportion of those with cancer that die with bone metastases, this suggests a minimum prevalence of all cancers at the time of death in medieval Britain to be approximately 9% to 14% of adults. CONCLUSIONS: This figure compares with a 40% to 50% prevalence of cancer at the time of death for modern Britain. The difference may be explained by the effects of modern carcinogens, the spread of viruses that trigger malignancy, industrial pollutants, and longer life expectancy.

Employing radiography (X‐rays) to localize lesions in human skeletal remains from past populations to allow accurate biopsy, using examples of cancer metastases

“…The bones of five medieval individuals from Cambridge and the surrounding area (United Kingdom) with known cancer metastases were used for this study. These cases have been published in detail elsewhere (Mitchell et al, 2021; Mitchell et al, 2022) and came from the medieval cemeteries at Edix Hill (PSN599), All Saints by the Castle (PSN737 and PSN796), Station Road Gamlingay (PSN807), and the Hospital of St. John the Evangelist (PSN160) (Figure 1). Lesions that had eroded through the cortical surface, and so were visible on inspection, were not included in this study.…”

“…A plain radiograph of the relevant bone containing the metastases was taken (Mitchell et al, 2021; Mitchell et al, 2022). Lesions large enough to be suitable for biopsy were identified and their approximate location noted.…”

The greatest health problem of the Middle Ages? Estimating the burden of disease in medieval England

“…Palaeopathological data gives rates of 0.17-1.79% for various forms of cancers (Roberts and Cox 2003:280-1). When skeletal remains are systematically screened radiographically, the prevalence is considerably higher (10-15% in adults (Mitchell et al, 2021)) and cancers may have been much more frequent in medieval times than usually supposed. However, this is based upon adults only; prevalences in the overall population would be lower depending upon the population age structure, and their lethality is unknown; they may also have caused significant chronic morbidity.…”

Plasmon-enhanced nano-photosensitizers: game-changers in photodynamic therapy of cancers

“…Industrialization and lifestyle changes are the two main reasons for increasing disease rates in civilization, and cancer is among the most lethal diseases. 1,2 Surgery, chemotherapy, and radiotherapy have been the most used methods for cancer treatment so far. [3][4][5] The efficiency and selectivity of these methods for different cancer types are under doubt, especially when the cancer is in the metastasis stage, and therefore a sustainable and promising method is still under exploration.…”