Over the past 2 decades, male pattern baldness has actually repeatedly and consistently been located to be associated along with an increased risk for prostate cancer in observational studies.
The tie makes theoretical sense in terms of physiology since androgens play a role in hair loss and prostate cancer development. Plus, the two conditions have actually a degree of heritability.
Nevertheless, the established risk factors for prostate cancer go on to be older age, black race, family history, and genetic aberrations, such as BRCA mutations.
But a brand-new study has actually added urgency to the question of whether or not baldness is likewise a risk factor.
For the initial time, researchers have actually located that baldness is tied to the risk for prostate cancer death.
In fact, the risk is 1.5 times better in bald men compared to in those along with no baldness, according to an analysis of data from the large American prospective, longitudinal cohort study known as the National Healthiness and Nourishment Examination Survey Epidemiologic Follow-up Study (NHEFS).
The outcomes were published in the February 1 issue of the American Diary of Epidemiology.
NHEFS is a “unique resource,” Michael Cook, PhD, an epidemiologist in the division of cancer epidemiology and genetics at the National Cancer Institute (NCI) in Bethesda, Maryland, and his colleagues report.
They explain that, of the various datasets used to prove to associations between baldness and prostate cancer, NHEFS is distinctive since it now has actually — for the initial time ever — a long enough median follow-up (21 years) to assess death risk. It likewise has actually a “significant advantage” since participants were dermatologically assessed for baldness at baseline.
The researchers looked at data on 4316 men in the NHEFS cohort who, at baseline (1971 to 1974), were 25 to 74 years of age and had no previous cancer diagnosis.
To date, there have actually been 3284 deaths in the cohort, 107 of which were caused by prostate cancer.
In multivariable models, the risk for fatal prostate cancer was 56% greater in men along with any sort of baldness compared to in those along with no baldness (hazard ratio [HR], 1.56; 95% self-confidence interval [CI], 1.02 – 2.37). In men along with moderate balding, specifically, the risk was 83% greater (HR, 1.83; 95% CI, 1.15 – 2.92).
Male baldness could play a small role in estimating risk of prostate cancer.
Despite the findings, baldness is not a certain risk factor for prostate cancer, Dr Cook said.
However, “it is conceivable that, in the future, patterns and degree of male baldness could play a small role in estimating risk of prostate cancer,” he told Medscape Medical News in an email.
An urologist not involved along with the study echoed these comments.
The 50% greater risk of disease-individual mortality is necessary However modest.
“The 50% greater risk of disease-individual mortality is necessary However modest,” said Stephen Freedland, MD, from the Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute in Los Angeles.
He given some context: various other studies have actually revealed that the risk is regarding 2.5 times greater in black men compared to in white men.
Furthermore, the risk elevation associated along with baldness is especially modest compared with, for example, the increased risk for lung cancer death associated along with smoking, he told Medscape Medical News.
Dr Freedland knows this subject well. In 2013, he and colleagues conducted a case–regulate study at a Veterans Affairs hospital of 708 men along with and devoid of prostate cancer (Cancer Sets off Control. 2013;24:1045-1052). They located that overall balding was associated along with a lot more compared to a twofold enhance in high-grade ailment (P = .02).
Those findings are akin to yet another study conducted by Dr Cook’s team, which showed an association between baldness and aggressive prostate cancer in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, as reported by Medscape Medical News.
“We located the exact same thing,” Dr Freedland reported.
Should Baldness Be Designated a Risk?
Overall, epidemiologic evidence of the link between baldness and prostate cancer is largely consistent, showing a modest association, the two Dr Cook and Dr Freedland acknowledged.
The moral of the story is that bald men have actually a greater risk of prostate cancer.
But Dr Freedland was a bit bolder in his interpretation of the data. “The moral of the story is that bald men have actually a greater risk of prostate cancer,” he said.
So, Ought to baldness be included as a risk factor for prostate cancer, also if it is merely as a modest one?
Not yet, said Dr Cook. “Replication of our outcomes is required, as is a much better mechanistic discovering of this association,” he explained.
“It’s not far off from prime time, However not there yet,” Dr Freedland added.
This will certainly be news to numerous urologists, he continued, since they don’t have the tendency to read epidemiology journals, where all the baldness and prostate cancer studies have actually been published. “Urologists in the United States read the Journal of Urology,” he asserted.
“Observations from epidemiology eventually migrate to the clinical world,” he explained, noting that also obvious cancer risk factors, such as smoking for lung cancer, started off as rarified epidemiologic findings.
What matters now, said Dr Freedland, is that research that seeks to elucidate the implications of baldness, as it relates to prostate biology, be funded. “We have to already know regarding androgen levels in the prostates of bald men,” he said.
There are various other places of this research that have to be explored further, including the relation between prostate cancer and distinct patterns of baldness, too as age at the onset of baldness, Dr Cook and his colleagues note.
Data on individual hair-loss scalp patterns in the NHEFS cohort are limited. Baseline baldness was assessed by trained third-year dermatology residents using a procedure that was standard in the 1970s.
Baldness was categorized in to four levels, However there was no differentiation between the bitemporal, frontal, and vertex areas. It is the vertex location that is now believed to especially enhance the likelihood of prostate cancer. Male pattern baldness was, however, differentiated from various other causes, such as trauma and alopecia areata, in the NEHFS cohort.
The study authors and Dr Freedland have actually disclosed no relevant financial relationships.
Am J Epidemiol. 2016;183:210–217. Abstract
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