Male pattern baldness linked to prostate Ca mortality

A large prospective study suggests men with male pattern baldness (MPB), particularly moderate MPB, are more likely to die from prostate cancer, compared to men with no MPB.

Philadelphia-A large prospective study suggests men with male pattern baldness (MPB), particularly moderate MPB, are more likely to die from prostate cancer, compared to men with no MPB.

These findings support the hypothesis that MPB and prostate cancer share some pathophysiologic mechanisms, explained lead author Cindy Ke Zhou, PhD, post-doctoral fellow at the National Cancer Institute, Bethesda, MD, who worked on the study with Michael B. Cook, PhD, and co-authors.

There are few established risk factors for the development of prostate cancer. These include advancing age, African-American ancestry, and a family history of the disease.

“The associations found in our study are important. Male pattern baldness is known to be associated with ‘male’ sex hormones (androgens) such as testosterone. We also know that testosterone is integral to prostate gland development and prostate cancer progression. We hope our findings will help guide mechanistic studies to uncover the relationship between androgens and this common malignancy among men,” Dr. Zhou said.

The same group of investigators previously showed an association between MPB at age 45 years and aggressive prostate cancer, published in the Journal of Clinical Oncology earlier this year (2015; 33:419-25). In that study, MPB was self-reported. The current study, which Dr. Zhou presented at the American Association of Cancer Research annual meeting in Philadelphia, is the first to look at prostate cancer-specific mortality, where MPB was assessed by dermatologists.

This study included 4,316 men from the NHANES-1 Epidemiologic Follow-up Study, who were 25–74 years of age and had no prior cancer diagnosis at study enrollment. Participants joined the study between 1971 and 1974. Trained dermatologists assessed the degree of MPB at study enrollment. During a median follow-up of 21 years, 3,284 deaths occurred in this cohort, 107 of which were due to prostate cancer.

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Balding increases death risk by 56%

In this analysis, men with any degree of MPB had a 56% increased risk of dying from prostate cancer compared to men with no balding. Men who had moderate MPB had an 83% increased risk of dying from prostate cancer, compared to men with no balding. The small number of patients with severe balding who died of prostate cancer limited the statistical power to detect a significant association for this category of hair loss. Conversely, MPB was not statistically significantly associated with all-cause mortality.

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“Results from previous studies on the association between circulating sex steroid hormones and prostate cancer risks are inconsistent. These studies have looked at circulating sex steroid hormone concentrations in the blood at a single time-point among men at mid-life or older, and these studies may not have adequately captured the etiologically relevant time-window(s) of androgen exposure. Therefore, we used MPB as a proxy of long-term androgen exposure,” Dr. Zhou explained.

“These findings need to be replicated in future studies,” she added. “It is still premature to recommend any practice changes related to prostate cancer screening, given the moderate association observed in our study and relatively high prevalence of male pattern baldness in the Western population.”