Age-Dependent Associations between Androgenetic Alopecia and Prostate Cancer Risk

Abstract

Background: Both prostate cancer and androgenetic alopecia are strongly age-related conditions that are considered to be androgen dependent, but studies of the relationship between them have yielded inconsistent results. We aimed to assess whether androgenetic alopecia at ages 20 and 40 years are associated with risk of prostate cancer.Methods: At a follow-up of the Melbourne Collaborative Cohort Study, men were asked to assess their hair pattern at ages 20 and 40 years relative to eight categories in showcards. Cases were men notified to the Victorian Cancer Registry with prostate cancer diagnosed between cohort enrollment (1990)(1991)(1992)(1993)(1994) and followup attendance (2003)(2004)(2005)(2006)(2007)(2008)(2009). Flexible parametric survival models were used to estimate age-varying HRs and predicted cumulative probabilities of prostate cancer by androgenetic alopecia categories.Results: Of 9,448 men that attended follow-up and provided data on androgenetic alopecia, we identified 476 prostate cancer cases during a median follow-up of 11 years four months. Cumulative probability of prostate cancer was greater at all ages up to 76 years, for men with vertex versus no androgenetic alopecia at age of 40 years. At age of 76 years, the estimated probabilities converged to 0.15. Vertex androgenetic alopecia at 40 years was also associated with younger age of diagnosis for prostate cancer cases.Conclusions: Vertex androgenetic alopecia at age of 40 years might be a marker of increased risk of earlyonset prostate cancer.Impact: If confirmed, these results suggest that the apparently conflicting findings of previous studies might be explained by failure to adequately model the age-varying nature of the association between androgenetic alopecia and prostate cancer. Cancer Epidemiol Biomarkers Prev; 22(2); 209-15. Ó2012 AACR.

Postscreening follow-up of the Finnish Prostate Cancer Screening Trial on putative prostate cancer risk factors: vitamin and mineral use, male pattern baldness, pubertal development and non-steroidal anti-inflammatory drug use

“…Age-adjusted prostate cancer risk (PCa) and mortality by self-reported vitamin use among 11,795 men participating in the third screening round of the Finnish Prostate Cancer Screening Trial. 9448 men, male pattern baldness at the age of 40 was associated with an increased risk of PCa, but later male type baldness at the age of 70 and over had a protective effect, and the cumulative probability for PCa between the groups converged at the age of 76 years [11]. This suggests that male pattern baldness at a certain age could be connected with earlier onset of PCa.…”

Male pattern baldness in relation to prostate cancer risks: An analysis in the VITamins and lifestyle (VITAL) cohort study

“…However, the median of baseline age was about 55 years, when baldness was assessed, and therefore baldness at younger age was not evaluated with sufficient statistical power. The Melbourne Collaborative Cohort Study (MCCS) predicted an 81% increased risk for prostate cancer at age 55 years, comparing vertex balding (Norwood-Hamilton stage III vertex –VII) with no balding at age 40 years [36]. This study also suggested that vertex balding at 40 years was associated with an average three-year earlier age at prostate cancer diagnosis [36].…”

“…The Melbourne Collaborative Cohort Study (MCCS) predicted an 81% increased risk for prostate cancer at age 55 years, comparing vertex balding (Norwood-Hamilton stage III vertex –VII) with no balding at age 40 years [36]. This study also suggested that vertex balding at 40 years was associated with an average three-year earlier age at prostate cancer diagnosis [36]. However, male pattern baldness was self-assessed after prostate cancer diagnosis, and men with aggressive prostate cancer were more likely to dropout from follow-up resulting in differentially missing self-reported hair-loss patterns.…”

Relationship of Early-Onset Baldness to Prostate Cancer in African-American Men

“…(12–14) Although most studies show some variability in prevalence depending on age, ethnic composition of the sample and study design (population-based vs. hospital-based and reference age for baldness), our results are similar to several other studies that support an increased prevalence of early onset baldness among prostate cancer cases and an association of baldness with early onset prostate cancer. (10, 16, 26) Unfortunately, the prevalence of early pattern baldness types among African-American prostate cancer cases and controls has not been documented.…”

“…Contrary to their findings, a recent large prospective study of 9,448 Australian men found that baldness at age 40 rather than age 20 was predictive of early onset prostate cancer. (26) It has been suggested that age 20 may be too early to observe associations of baldness on prostate cancer, as many men that will experience early onset baldness have not yet begun balding by that age. An age range between 30–40 seems more appropriate as a reference point to avoid misclassification of early pattern baldness and is also a closer timepoint to prostate cancer diagnosis and related processes.…”