CANCER AS EVIDENCE: FORENSIC IMPLICATIONS IN DISEASE AND DEATH; A NARRATIVE REVIEW

Abstract

Background: Cancer, while long considered a clinical concern, is increasingly recognized for its forensic relevance. Beyond its pathological manifestations, malignancy can complicate cause-of-death investigations and carry implications for legal accountability. Its ability to mimic trauma, induce fatal thrombotic events, or result from environmental and occupational exposures positions cancer as a critical but underexplored element in forensic science.

Objective: This narrative review aims to explore the intersection of oncology and forensic medicine, emphasizing the diagnostic, medico-legal, and evidentiary roles that cancer can play in death investigations. The review synthesizes recent advancements in molecular diagnostics and highlights their application in forensic pathology.

Main Discussion Points: The review discusses how cancer can be a primary, contributory, or incidental cause of death, and how its presentation may mimic trauma or natural diseases. It explores the forensic implications of cancer-associated thrombosis, toxicological exposures, and occupational carcinogens. Advanced molecular techniques such as next-generation sequencing (NGS), epigenetic profiling, liquid biopsy, digital pathology, and molecular autopsy are examined for their potential in clarifying cause and manner of death in complex cases. Ethical, legal, and genetic considerations, especially concerning hereditary cancer syndromes, are also addressed.

Conclusion: Cancer is both a pathological condition and a potential source of forensic evidence. Its integration into forensic investigations, supported by molecular and imaging technologies, enhances the accuracy of death certification and medico-legal accountability. Further research and standardized guidelines are needed to solidify forensic oncology as a core component of modern death investigation.