When we think of causes of death in the Middle Ages most people probably think of plague, famine and getting on the wrong end of a sword. Cancer probably isn't high on the list, but a new study suggests it was a lot more common than previously thought. Not every cancer was fatal of course, particularly with so many quicker causes of death around, but it may have been a surprisingly common killer.
Cancers are becoming more common, a consequence of both lifestyle and environmental factors, and because increased survival from other things means more of us are living to ages where vulnerability rises. As the International Agency for Research on Cancer puts it; “Generally, cancer rates are highest in countries whose populations have the highest life expectancy, education level, and standard of living.” For this reason, despite exceptions for a few cancers that show the reverse trend, it seems logical to extrapolate back to a largely cancer-free per-industrial era.
When Dr Piers Mitchell of the University of Cambridge examined 143 skeletons of people who died between 500 and 1600 AD, he didn't expect to find a lot of tumors. Nevertheless, he thought the true figure might be higher than the less than 1 percent found in previous studies. Mitchell noted in a statement; "The majority of cancers form in soft tissue organs long since degraded in medieval remains. 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,”
CT scans revealed visible evidence in five cases (3.8 percent), all of whom were male. Allowing for the fact that around 50 to 60 percent of soft tissue tumors today never spread to bones, Mitchell and co-authors conclude in Cancer that nine to 14 percent of the population of England during this period got cancer. The types of cancer could usually not be confirmed, although some could be ruled out.
That's still much less than today, where 40 to 50 percent of the British public have cancer by the time they die, whether or not it is the thing that kills them. Still, given the shorter life-expectancy, lack of air pollution or tobacco and all the extra exercise people of the era got, it's interesting to learn cancer may have actually been a significant problem even then.
The bones used for the study came from six cemeteries in and around Cambridge. Most of the bodies exhumed were incomplete, so for consistency the team restricted themselves to those where the spinal column, pelvis and thigh bones were all available for study.
More than twice as many male skeletons met the criteria than female ones, which may have skewed the results slightly. The authors also stress the small sample size and limited geographic range. Perhaps Cambridgeshire was a cancer hotspot for some unknown reason. Alternatively, maybe the world we have escaped was even worse than we thought, particularly since treatments back then would have offered little relief.