What can an evolutionary perspective on women’s health provide to the current public health paradigm? A case study on redefining thyroid cancer as a reproductive cancer

Abstract

AbstractIncidence rates of non-communicable diseases in women are increasing worldwide and now contributing more to mortality and morbidity than reproductive health. Despite this universal trend, there is no recognition by the WHO of this phenomenon in women’s health. Additionally, thyroid cancer is considered a non-sex specific cancer despite female incidence rates being triple those of males. To understand why there are such conceptual limitations to women’s health, biomedicine - and its prevalence in western public health authorities - will be analysed from an anthropological perspective. In mind of these conceptual limitations, insights from evolutionary perspectives on health are introduced as well as how they may alleviate the conceptual barriers in the current biomedical paradigm. Using the example of breast cancer, the difference between a reproductive cancer in women, and cancer located in the reproductive tract will be explored. From this, the possibility that a cancer outside the reproductive tract can be directly influenced by reproductive function is explored in the specific case of thyroid cancer. Thyroid cancer and current public health approaches to preventing malignancies of the thyroid are examined to show the limitations of their scope. Furthermore, evidence supporting the direct link between thyroid function and reproductive function is presented. Current academic studies into the link between thyroid cancer and women’s reproductive function are analysed to show they are subject to the same conceptual limitations of women’s reproductive function as found previously in biomedicine. To conclude, I will introduce a new hypothesis for exploring the impact of women’s reproductive function on thyroid cancer incidence rates. This hypothesis will allow women’s health to be viewed holistically, and allows reproductive function to be investigated beyond parity. Thus, the conceptual limitations of women’s health in the public health paradigm will be alleviated.