Baldness Increases PCa Risk

ATLANTA—Androgenic alopecia, also known as male pattern baldness, is significantly associated with an elevated risk for prostate cancer (PCa), researchers reported at the American Urological Association 2012 annual meeting.

In a prospective study of 196 consecutive patients referred for prostate biopsy, David Margel, MD, and colleagues at the University of Toronto, and colleagues found that the more severe the pattern baldness, the greater the risk for PCa. Frontal balding was associated with a 2.0 times increased risk, whereas mild, moderate, and severe vortex balding was associated with a 2.1, 2.5, and 2.9 times increased risk, after adjusting for age, digital rectal examination (normal vs. abnormal), and PSA level.

The study, which was led by Neil E. Fleshner, MD, Professor of Urology at the University of Toronto, also looked at whether the ratio of the lengths of the index and ring fingers predicted PCa and found no association. Previous retrospective studies have suggested that a low ratio, which indicates high prenatal androgen exposure, is associated with PCa.

Androgens play a role in the development of both androgenic alopecia and PCa. Previous retrospective studies have shown a relationship between male pattern baldness and PCa. For example, French researchers reported in Annals of Oncology (2011;22:1824-1827) that patients with PCa were twice as likely to have androgenic alopecia at age 20 compared with non-PCa patients.

Dr. Margel said the findings of the new study are preliminary, so at this point they should not alter clinical decision making. “However, our next step is to test whether adding patterns of hair loss may augment current prediction models for prostate biopsies,” he said. “This should be done on a larger cohort and preferably in the primary care setting.”

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