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Male Pattern Baldness at Age 45 May Be Associated With Aggressive Prostate Cancer

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Key Points

  • Frontal plus moderate vertex baldness was associated with increased risk of aggressive prostate cancer.
  • No other baldness pattern was significantly associated with prostate cancer risk.

In a prospective cohort study in the population of the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, Zhou et al found that frontal plus moderate vertex baldness at age 45 is associated with increased risk of aggressive prostate cancer. The findings were reported in the Journal of Clinical Oncology.

Study Details

The study included 39,070 men (89.3% white) from the usual care and screening arms of the PLCO cohort who had no cancer diagnosis (excluding nonmelanoma skin cancer) at the start of follow-up and who recalled their hair-loss pattern at age 45 years. Male pattern baldness at age 45 years was reported by 53.4%, consisting of 46.4% with frontal baldness only, 23.5% with frontal plus mild vertex baldness, 18.1% with frontal plus moderate vertex baldness, and 12.0% with frontal plus severe vertex baldness.

During median follow-up of 2.78 years, 1,138 men had a diagnosis of prostate cancer; of these, 571 cases were aggressive, as defined by biopsy Gleason score ≥ 7, clinical stage III or higher, or fatality.

Differences in Men With vs Without Cancer

Compared with men without prostate cancer, men with aggressive prostate cancer were more likely to be in the usual care arm, married/cohabiting, and have history of enlarged prostate and were less likely to ever smoke; men with nonaggressive prostate cancer were more likely to be married/cohabiting, have family history of prostate cancer, and have history of enlarged prostate and were less likely to ever smoke and to have a history of diabetes or myocardial infarction (all P < .05).

Increased Risk of Aggressive Disease

Compared with no baldness, frontal plus moderate vertex baldness at age 45 years was not associated with significantly increased risk for prostate cancer overall (hazard ratio [HR] = 1.19,  95% confidence interval [CI] =0.98–1.45) or for nonaggressive prostate cancer (HR = 0.97, 95% CI = 0.72–1.30), but was associated with significantly increased risk of aggressive prostate cancer (HR = 1.39, 95% CI = 1.07–1.80). Hazard ratios were unchanged (1.19, 1.39, and 0.96) on multivariate analysis adjusting for screening arm and center, race, education level, marriage status, presence of diabetes, body mass index at age 50 years, cigarette smoking status, aspirin use frequency, and history of myocardial infarction.

No other categories of baldness had significant associations with overall risk of prostate cancer or risk for nonaggressive or aggressive disease.

The investigators concluded: “Our analysis indicates that frontal plus moderate vertex baldness at age 45 years is associated with an increased risk of aggressive prostate cancer and supports the possibility of common pathophysiologic mechanisms.”

Michael B. Cook, PhD, of the National Cancer Institute, is the corresponding author for the Journal of Clinical Oncology article.

The study was funded by the National Cancer Institute. The study authors reported no potential conflicts of interest.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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