Could Hair Loss at 20 Signal Higher Prostate Cancer Risk?

Researchers say these men may turn out to be candidates for screening, but more study needed

Feb 2011

Men with prostate cancer may be twice as likely to have started showing signs of male pattern baldness at the age of 20 than those without prostate cancer, a new French study suggests.

Men who start losing their hair in their 30s or 40s do not appear to face a similar boost in prostate cancer risk. And those whose hair loss starts in their 20s do not face a higher risk of developing the cancer at an early age or of developing more aggressive tumors, the research team noted.

Whether or not men who experience youthful hair loss may benefit from prostate cancer screening is yet to be determined, the study authors added.

"At present, there is no hard evidence to show any benefit from screening the general population for prostate cancer," study author Dr. Philippe Giraud, from the European Georges Pompidou Hospital in Paris, said in a news release from the European Society for Medical Oncology. "We need a way of identifying those men who are at high risk of developing the disease."

Noting that androgens associated with hair loss are also associated with prostate cancer, he and the other researchers called for more studies to see whether interventions might be appropriate for men with very early balding.

Physicians need to know "who could be targeted for screening and also considered for chemo-prevention using anti-androgenic drugs such as finasteride," Giraud said.

"Balding at the age of 20 may be one of these easily identifiable risk factors, and more work needs to be done now to confirm this," he added.

Giraud, who is also a professor of radiation oncology at the Paris Descartes University, reports his team's findings in the Feb. 15 online edition of the journal Annals of Oncology.

The authors noted that male pattern baldness (androgenic alopecia) is very common, affecting about half of all men at some point in their lives.

Its onset has previously been linked to the conversion of testosterone to androgenic hormones, and androgens have also been previously implicated in the onset and growth of prostate cancer.

The drug finasteride -- used to treat baldness -- blocks the conversion of testosterone to an androgen thought to cause hair loss, and the drug has also been demonstrated to lower the incidence of prostate cancer.

To explore the possible connection between balding patterns and prostate cancer, the research team spent more than two years analyzing disease progression and hair loss patterns in 388 men with prostate cancer.

The men were diagnosed between the ages of 46 and 84. Starting in 2004, the investigators asked them to indicate whether or not they had experienced any previous balding, when their hair loss began, and specifically what type of hair loss had occurred at 20, 30 and 40.

Another 281 healthy men were enlisted in the study for comparison.

The research team found that 37 of the prostate cancer patients (and 14 of the healthy men) had experienced some form of hair loss at the age of 20, ranging from a receding hairline to a bald patch at the top of the head, or a combination of both.

Any form of hair loss at age 20 was linked to a doubling of prostate cancer risk, the study authors reported, with no specific pattern of hair loss being more predictive of risk than any other.

The research team cautioned, however, that it is premature to conclude that baldness and prostate cancer are, in fact, linked.

For his part, Dr. Nelson Neal Stone, a clinical professor of urology and radiation oncology at Mount Sinai School of Medicine in New York City, agreed that while "the study is food for thought," it is in no way conclusive.

"First of all, the number of patients involved is very low, which makes interpretation and application to the general population very risky," he said.

"But we do know that there are genetic factors that make prostate cancer more prevalent," Stone said. "For example, men who have a first-degree relative -- an uncle, father or brother -- who have a diagnosis of prostate cancer are 2.5 to three times more likely to develop prostate cancer themselves than men who don't have such a history. And genetics also plays a role in men who develop early hair loss."

"So, you have two genetically related factors that there may be an association from, and each may be linked to early high male hormone levels. So it may be a hormonally related situation," Stone acknowledged. "But it's very hard to prove."

More information For more on prostate cancer risk, visit the American Cancer Society.

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