The impact of industrialization on malignant neoplastic disease of bone in England: A study of medieval and industrial samples

Objective: The increasing prevalence of malignant disease has been associated with shifts in environmental, socioeconomic, and lifestyle risk factors as well as increased adult lifespan. We examine the relationship between malignant neoplasms affecting bone, age and industrialization.

Materials: Pre-existing skeletal data from 11 medieval (1066-1547, n = 8973) and 14 industrial (1700-1890, n = 4748) cemeteries (N = 13,721) from England.

Methods: Context number, sex, age-at-death, evidence of skeletal malignancy, and diagnosis were collated. The data were compared using chi square, Kolmogorov-Smirnov tests and logistic regression (α = 0.01).

Results: There was a statistically significant increase in skeletal malignancy from 0.06 % in the medieval sample to 0.36 in the industrial sample (p < 0.001). Age had a strong relationship with malignancy (p = 0.003), sex did not (p = 0.464). Logistic regression revealed that time-period (p < 0.001) was a stronger predictor of skeletal malignancy than age-at-death (p = 0.002).

Conclusion: Our results confirm that even with the temporal increase in adult human lifespan the increase of malignant neoplasms of bone between the medieval and industrial time periods is still statistically significant.

Significance: The augmented exposure to carcinogens and pollution during the Industrial Revolution had a strong effect on an individual's susceptibility to developing malignant disease of bone.

Limitations: This meta-analysis relies upon previously gathered data and diagnosis from a large number of researchers and did not include radiographic or CT screening. Only malignant neoplasms that affected bone could be included.

Suggestions for further research: Increasing excavation and analysis of post-medieval cemeteries will provide more data. Multimethod approaches (radiography, CT, Micro-CT and histology) are encouraged.