Men who start losing their hair aged 20 are more than twice as likely to develop prostate cancer in later life, concludes a study published in Annals of Oncology.  Men with early hair loss, the French authors believe, might benefit from more regular screening.

A link has been established between androgenic alopecia, sometimes known as male pattern baldness, and androgenic hormones.  Furthermore, androgens are known to play a role in the development and growth of prostate cancer.  Indeed, the drug finasteride blocks the conversion of testosterone to dihydrotestosterone (the active metabolite) thereby slowing the progression of baldness and decreasing the incidence of prostate cancer.   Yet despite this, the direct link between male pattern baldness and prostate cancer has not been consistently shown.

 Philippe Giraud and colleagues, from the Paris Descartes University and the European Georges Pompidou Hospital (Paris) undertook a case-controlled study comparing 388 successive men being treated for prostate cancer (n=388) with healthy age matched controls (n=281). Participants were asked to answer a questionnaire about their personal history of prostate cancer (if any) and to score the balding patterns they had at ages 20, 30, and 40 years according to a set of four pictures. The first picture represented no balding, the second showed frontal hair loss, the third vertex hair loss, while the fourth showed both frontal and vertical balding.

Results showed that any balding present at age 20 was associated with an increased incidence of prostate cancer in later life. When compared with controls, patients with prostate cancer were twice as likely to report androgenic alopecia at the age of 20 years - (OR 2.01, P=0.0285, CI 1.07-3.79).

The trend was lost at ages 30 and 40 years, and the actual pattern of hair loss was not found to be a predictive factor for the development of cancer. Furthermore, no association was found between early-onset alopecia and earlier diagnosis of prostate cancer, or with the development of more aggressive tumours.

“At present there is no hard evidence to show any benefit from screening the general population for prostate cancer,” said Giraud. “We need a way of identifying those men who are at high risk of developing the disease and who could be targeted for screening and also considered for chemoprevention using anti-androgenic drugs such as finasteride. Balding at the age of 20 may be one of these easily identifiable risk factors.”

The authors call for further work to be under taken, both at the molecular level and with larger groups of men, to find the missing link between androgens, early balding and prostate cancer.

Reference.

Yassa M, Saliou M, De Rycke Y et al. Male pattern baldness and the risk of prostate cancer. Annuals of Oncology. Doi: 10.1093/annonc/mdq695.