Fatal Prostate Cancer Linked to Balding
Any baldness is associated with a 56% higher risk of dying from the malignancy.
Men with any degree of baldness have an increased risk of dying from prostate cancer (PCa), according to a recent study.
“In the future, patterns and degree of male baldness may play a small role in estimating risk of prostate cancer and may contribute to patient-doctor discussions about whether to opt for prostate cancer screening,” lead investigator Michael Cook, PhD, of the National Cancer Institute in Bethesda, MD, told Renal & Urology News.
Using male pattern baldness as a proxy for long-term androgen exposure, Dr. Cook and colleagues studied PCa-specific mortality and extent of baldness in 4,316 men aged 25–74 years from the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study (1971–1974).
Of 3,284 deaths occurring during 21 years of follow-up, 107 were due to PCa, according to results published in the American Journal of Epidemiology. Compared with no balding, having any degree of baldness was associated with a 56% higher risk of fatal PCa, after adjusting for potential confounders such as age, race, and body mass index. Moderate balding, defined as observable baldness by a dermatologist at baseline, was associated with an 83% increased risk. Patterned hair loss was not associated with all-cause mortality.
The investigators believe their findings support their hypothesis that PCa and androgenic alopecia have overlapping pathophysiologic mechanisms from heritable factors and endogenous hormones; both hair follicles and the prostate gland are androgen responsive.
The new findings support some previous studies linking PCa to balding (such as vertex or frontal balding patterns). For example, in a study of 39,070 men in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, a team led by Dr. Cook found that, compared with no baldness, frontal plus moderate vertex baldness at age 45 years was associated with a significant 39% increased risk of aggressive PCa, according to a paper published in the Journal of Clinical Oncology (2015;33:419-425). In an earlier study of 4,421 men aged 25–75 years without a history of PCa who participated in the first National Health and Nutrition Examination Survey, Ernest Hawk, MD, MPH, and colleagues at the National Cancer Institute found that male pattern baldness was associated with a 50% increased relative risk of PCa, regardless of baldness severity and independent of other risk factors, such as race and age, according to a report in Cancer Epidemiology, Biomarkers & Prevention (2000;9:523-527).
Not all studies examining the relationship between balding and PCa have found a connection, however. For example, Dr. Cook and colleagues reported in The Prostate (2015;75:415-423) that they found no significant association between pattern baldness and overall PCa and PCa subtypes in a study of 32,583 men aged 50–76 years in the VITamins And Lifestyle (VITAL) cohort study.
The authors noted that the moderate association and relatively high prevalence of male pattern baldness in Western populations “does not currently support the use of male pattern baldness in prostate cancer screening decisions.”
In the meantime, patients experiencing hair loss should not fret. At the lower confidence limits, the findings suggest just a 2% increased risk of fatal PCa in men with any balding and a 15% increased risk in men with moderate balding, according to Dr. Cook. “Men with any degree of baldness should not be additionally concerned about their individual risk of developing, or dying from, prostate cancer,” he stated.