Balding at 20 Linked to Higher Prostate Cancer Risk

Men who show signs of balding at age 20 are twice as likely to develop prostate cancer in their lifetimes as those who keep their manes or lose them later, according to a French study.

Neither balding at 30 or 40 years of age, nor the pattern of hair loss, pointed to any increased risk of developing the disease, the researchers wrote in the medical journal Annals of Oncology. Early hair loss wasn’t associated with an earlier onset of cancer or a more severe course of the disease, the study found.

Researchers have long known that men who more readily convert the male hormone testosterone into a form called DHT have a higher risk of prostate cancer and are more likely to go bald. Understanding that relationship better may help doctors identify men who may be helped by cancer screening, said Michael Yassa, a radiation oncologist who helped conduct the study.

“There’s a big debate about who can really benefit from prostate cancer screening” with the PSA test that’s used to predict risk of the malignancy in men, said Yassa, who now works at Maisonneuve-Rosemont Hospital in Montreal.

Studies have shown that men who have elevated levels of the protein measured by the PSA test don’t always have prostate cancer. Some may end up getting unnecessary procedures and surgeries based on the test results. Those findings have raised questions about whether PSA testing is useful and which men should get the test.

Bald at 20?

“We’re saying ‘OK, if we can’t have consensus on the general population, can we get a consensus on people who are at higher risk,’” Yassa said yesterday in a telephone interview. “With balding we don’t need to do any tests. When they walk into the clinic, we can say, ‘Were you bald at 20 or 30? If so, you may be at higher risk of getting prostate cancer.’”

Giraud and his colleagues questioned 669 men, of whom 388 had prostate cancer, about their hair status at different ages. The men classified their hair pattern according to a modified version of a widely used measure of baldness called the Hamilton-Norwood scale, and the researchers asked physicians about details of the participants’ illness.

The cancer forms in the tissue of the prostate, a gland in the male reproductive system lodged between the bladder and the rectum, according to the U.S. National Cancer Institute. There were an estimated 217,730 new cases of prostate cancer in the U.S. last year, and 32,050 deaths, according to the institute.

Unnecessary Treatment

Screening men for prostate cancer saves few lives and may lead to unnecessary treatment, according to a study published last year in the British Medical Journal.

The American Cancer Society, in its revised guidelines, says men should only be screened for the disease if they have been told of the possibility of misleading test results and side effects of treatments that in some cases may pose more harm than the cancer itself. Side effects of therapies include incontinence, erectile dysfunction and other complications, according to the National Cancer Institute.

The U.S. Preventive Services Task Force, an independent panel of experts composed mostly of physicians, says there isn’t enough evidence to assess the balance of benefits and harms in men under age 75 and recommends against prostate cancer screening in men 75 or older, according to its website. The men in the study who had prostate cancer were diagnosed from the ages of 46 to 84.

The results of the study aren’t enough to make firm recommendations that men who go bald while they’re young should get PSA tests at a certain age, Yassa said. They support the idea that the mechanisms that lead to hair loss and development of prostate cancer are related and that more study may better explain the links, he said.

(Corrects U.S. Preventive Services Task Force recommendations in 11th paragraph of article published Feb. 16.)
Before it's here, it's on the Bloomberg Terminal. LEARN MORE