The Effect of Cancer and Cancer Treatment on Pubic Symphysis Age Estimation Using Computed Tomography Scans

TL;DR

This study investigates whether cancer and its treatment affect age estimation from CT scans of the pubic symphysis in skeletal remains.

Contribution

The study is the first to examine the impact of cancer on CT-based skeletal age estimation using the Suchey–Brooks method.

Findings

Females with cancer had a 74.7% correct age estimation rate, compared to 85.1% for those without cancer.

Males with cancer had a 46.0% correct age estimation rate, compared to 55.7% for those without cancer.

CT scans may lack the resolution to detect subtle bone changes caused by cancer or its treatment.

Abstract

It is currently unknown whether cancer and cancer treatment affect age-related skeletal changes used in the biological profile for skeletonized remains. This research examines the effects of cancer on skeletal age estimation using computed tomography (CT) scans of the pubic symphyses for 307 individuals from the New Mexico Descendent Image Database. The Suchey–Brooks method was applied to 125 individuals without documented cancer and 182 individuals with documented cancer. Individuals were correctly aged if their chronological age fell within the original study’s 95% prediction range. Though not statistically significant, the results show that females with cancer were aged correctly 74.7% of the time, and females without cancer were aged correctly 85.1% of the time; males with cancer were aged correctly 46.0% of the time, and males without cancer were aged correctly 55.7% of the time. Additionally, a total of 30 individuals were reanalyzed to examine intraobserver error, and a Cohen’s kappa value of k = 0.600 indicated a moderate level of agreement. While no statistical differences were found between cancer and control groups, CT scans may lack the resolution needed to visualize the nuanced effects of bone mineral density loss, if present, and the overall quality of bone, despite their proven utility in dry-bone skeletal analyses.

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