Cancers as rare diseases: Terminological, theoretical, and methodological biases

Authors

Carina Marques, The University of Texas Rio Grande ValleyFollow
Charlotte Roberts
Vitor M. J. Matos
Jane E. Buikstra

Document Type

Article

Publication Date

3-2021

Abstract

Objective

Was cancer a rare disease in the past? Our objective is to consider the various terminological, theoretical, and methodological biases that may affect perceptions of the rarity of cancer in the past.

Materials and methods

We discuss relevant malignant neoplastic biomedical and paleopathological literature and evaluate skeletal data. We selected 108 archaeological sites (n = 151 cancer cases) with published malignant neoplasms and that were amenable to calculating cancer crude prevalence. Furthermore, datasets from four medieval/postmedieval Portuguese and 12 postmedieval UK sites were used to compare age-adjusted rates for metastatic bone disease and tuberculosis.

Results

In the literature review, mean cancer crude prevalence (1.2 %; 95 % CI = 0.96–1.4) exceeded the threshold for a rare disease (RD). Age-standardized rates of MBD and TB were not markedly different in the sites surveyed.

Conclusions

Methodological, theoretical and historical factors contribute to assumptions that cancers were rare diseases. The assumption that cancers are extremely rare in the paleopathological literature was not fully supported. Cancer is a heterogeneous concept, and it is important to view it as such. If a disease is considered rare, we may fail to recognize it or dismiss it as unimportant in the past.

Significance

We present a re-evaluation of the idea that cancer is a rare disease. We present a more nuanced way of comparing rates of pathological conditions in archaeological contexts.

Limitations

Variation in the amount of useable information in published literature on malignant neoplasms.

Suggestions for further research

More large-scale studies of cancer in the past alongside comparative studies of cancer prevalence with other assumed rare diseases.

Comments

Original published version available at https://doi.org/10.1016/j.ijpp.2020.12.005

Recommended Citation

Marques, Carina, et al. "Cancers as rare diseases: Terminological, theoretical, and methodological biases." International Journal of Paleopathology 32 (2021): 111-122. https://doi.org/10.1016/j.ijpp.2020.12.005

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

Publication Title

International Journal of Paleopathology

DOI

10.1016/j.ijpp.2020.12.005