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

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.

Keywords: Suchey–Brooks method; biological profile; cancer; computed tomography scans; forensic anthropology; pubic symphysis.

Figure 1

Suchey–Brooks Phase II left pubic symphysis. (a) AMAB aged 23 years, visualization of ridges and furrow on symphyseal face. (b) AFAB aged 36 years, visualization of ridges and furrows on symphyseal face.

Figure 2

Suchey–Brooks Phase III left pubic symphysis. (a) AMAB aged 33 years, visualization of complete dorsal plateau. (b) AFAB aged 53 years, visualization of complete dorsal plateau.

Figure 3

Suchey–Brooks Phase IV left pubic symphysis. (a) AMAB aged 48 years, visualization of complete oval outline. (b) AFAB aged 48 years, visualization of complete oval outline.

Figure 4

Suchey–Brooks Phase V left pubic symphysis. (a) AMAB aged 62 years, visualization of moderate lipping. (b) AFAB aged 54 years, visualization of slight depression of the face.

Figure 5

Suchey–Brooks Phase VI left pubic symphysis. (a) AMAB aged 58 years, visualization of depressed symphyseal face and ligamentous outgrowths. (b) AFAB aged 86 years, visualization of depressed symphyseal face and porosity.