Does going bald young increase your risk for prostate cancer?

Well … perhaps … maybe … according to a recent study by a group of French researchers.

Because it is known that androgen levels affect risk for male pattern baldness, and androgens are also involved in the development of prostate cancer over time, Yassa et al. decided to investigate whether the early onset of baldness was associated with an increased risk of prostate cancer later in life.

They enrolled a total of 669 men with a history of hair loss and then asked these men to “look back” and score their balding patterns over time — at ages of 20, 30, and 40 years.

Here is what they found:

  • 388/669 men (58.0 percent) had a history of prostate cancer and 281/669 (42.0percent) had no history of prostate cancer.
  • The men with a history of prostate cancer were twice as likely to have androgenic alopecia at age 20 [(ratio [OR] = 2.01, P = 0.0285).
  • The pattern of hair loss was not predictive for the development of prostate cancer.
  • There was no association between the early onset of hair loss, early diagnosis of prostate cancer, or with development of more aggressive disease.

All that this study really tells us is that there is an “association” between early onset of hair loss and the subsequent development of prostate cancer.

The authors have also reported that there was no difference in the apparent family history of prostate cancer between the patients with and without a personal history of prostate cancer, but the study did not control for things like African ancestry or other factors, so it is hard to know any more than the fact that there is some sort of association between the two categories of event.

Whether the early hair loss is actually predictive for later prostate cancer or whether it is simply an associated finding would be impossible to tell on the basis of these data. And then of course there is the accuracy of the memories of the subjects. Just how really bald were they at age 20 or 30? Is there confirmatory photographic evidence?

3 Responses

  1. Amusing

  2. There are a number of causes of hair loss, including androgen related hair loss due to DHT, as I understand it. That androgenic hair loss is the one that had a significant connection with prostate cancer in this study.

    It would be helpful if the researchers could disregard the non-androgenic cases, considering them as noise, and home in on the androgenic cases, hopefully measuring circulating DHT levels in the scalp and prostate. I realize this is likely to be not practical, but it could help clarify the issue.

    By the way, I started regrowing hair in the male pattern baldness area within weeks of commencing 5 mg of finasteride daily (for prostate cancer as part of triple blockade). That’s not a universal side effect, but I’m glad I was one of those so affected.

    I read the entire paper and noted the continued, regrettable influence of the two deeply flawed screening studies (ERSPC and PLCO, published in the New England Journal of Medicine). This paper cited them as evidence of the questionable value of screening, despite the fact that the study periods were too short to ascertain the true impact of screening, among other serious flaws.

  3. Dear Jim: It is entirely true that the PLCO and ERSCP studies were so deeply flawed that it would not have been possible for either of them to provide an accurate assessment of the potential value of regular mass, population-based screening on prostate cancer mortality — but I have to point out that the length of folow-up of patients in the studies was only one of the major flaws in both of these studies. Frankly, they were both so deeply flawed in other ways that were inherent in the study designs that it is hard to make heads or tails of the results anyway. All interpretation of the data from these two trials is fundamentally dependent on the assumptions people make in the statistical analysis of the core data.

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