Link May Exist Between Baldness and Aggressive Prostate Cancer

Oncology Live Urologists in Cancer Care®, October 2014, Volume 3, Issue 5

If a man has a certain pattern of baldness when he reaches 45 years of age, he faces a 45% higher risk of developing aggressive prostate cancer later in life than does a man with no baldness at that age.

Michael B. Cook, PhD

If a man has a certain pattern of baldness when he reaches 45 years of age, he faces a 45% higher risk of developing aggressive prostate cancer later in life than does a man with no baldness at that age.

So found the authors of a large analysis from the prospective Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. Their research was published September 15 in the Journal of Clinical Oncology.

“Our study found an increased risk for aggressive prostate cancer only in men with a very specific pattern of hair loss, baldness at the front and moderate hair-thinning on the crown of the head, at the age of 45. But we saw no increased risk for any form of prostate cancer in men with other hair-loss patterns,” said senior study author Michael B. Cook, PhD, an investigator in the Division of Cancer Epidemiology and Genetics at the National Cancer Institute in Bethesda, MD, in a statement released by the American Society of Clinical Oncology. “While our data show a strong possibility for a link between the development of baldness and aggressive prostate cancer, it’s too soon to apply these findings to patient care.”

There is emerging evidence of a biological link between prostate cancer and male pattern baldness, because both are associated with increased levels of androgens and androgen receptors, ASCO noted in the statement. But results from previous studies have been inconsistent, the authors wrote.

To analyze male-pattern baldness in relation to prostate cancer risk, the researchers enrolled 39,070 men from the usual-care and screening arms of the US Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial who did not have cancer (except, in some cases, nonmelanoma skin cancer), and followed them for a median 2.78 years, the authors wrote. The men, ages 55-74 years, were given a questionnaire at the outset of the study that included a pictorial tool and asked them to recall their hair-loss patterns at age 45, ASCO stated.

During the course of the study, 1138 of the men were diagnosed with prostate cancer, with 50% of those cases classified as aggressive (stage III or IV with a Gleason score of 7 or higher, or prostate cancer as the cause of death). The mean age of the men at the time of prostate cancer diagnosis was 72 years, ASCO noted.

Compared to men who experienced no baldness at age 45, those who demonstrated a specific pattern of frontal and moderate-crown baldness were 40% more likely to eventually develop aggressive prostate cancer, the authors found. There was no association between male-pattern baldness and risk of non-aggressive prostate cancer, nor was there any association between other classes of baldness and prostate cancer.

If the findings are confirmed by other studies, this type of baldness may be used by physicians to help identify men who face an increased risk of developing aggressive prostate cancer, Cook told ASCO.

His research team is now conducting two additional studies on the relationship between male-pattern baldness and the risk of developing and dying from prostate cancer. One study is administering a baseline dermatologic assessment of male-pattern baldness, which may be more reliable than the recall method used by the team in the study it just published, ASCO noted.

Charles J. Ryan, MD, an expert selected by ASCO to comment on the study, said that the team’s work helps solidify the idea that a link might exist between baldness and prostate cancer.

“Previous research linking baldness and prostate cancer has been inconclusive, but this large study suggests a significant link between high-risk prostate cancer and hair loss—and suggests that men with hair loss may need to be followed more closely,” said Ryan, a professor of Medicine at the Helen Diller Family Comprehensive Cancer Center at the University of California, San Francisco and the leader of the Genitourinary Medical Oncology Program there.


Zhou CK, Pfeiffer RM, Cleary SD, et al. Relationship between male pattern baldness and the risk of aggressive prostate cancer: an analysis of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. J Clin Oncol. Published online September 15, 2014.