Liaquat University of Medical and Health Sciences, Sindh, Pakistan.
Harvard Medical School, Boston, Massachusetts.
Cancer Epidemiol Biomarkers Prev. 2020 Jun;29(6):1229-1236. doi: 10.1158/1055-9965.EPI-19-1236. Epub 2020 Apr 10.
The association between male pattern baldness and prostate cancer has been inconsistent. We prospectively investigated the association between baldness at age 45 and prostate cancer risk in the Health Professionals Follow-up Study (HPFS), focusing on clinical and molecular markers.
Baldness was self-reported on the 1992 questionnaire using the modified Norwood-Hamilton scale prior to diagnosis. We estimated HRs between baldness and prostate cancer risk among 36,760 men, with follow-up through 2014. We also investigated whether baldness was associated with prostate cancer defined by tumor protein expression of androgen receptor and the presence of the TMPRSS2:ERG fusion.
During 22 years, 5,157 prostate cancer cases were identified. Fifty-six percent of the men had either frontal or vertex baldness. No significant associations were found between baldness and prostate cancer risk. Among men younger than 60 years, there was a statistically significant association between frontal and severe vertex baldness and overall prostate cancer (HR: 1.74; 95% confidence interval: 1.23-2.48). Baldness was not significantly associated with expression of molecular subtypes defined by AR and TMPRSS2:ERG IHC of prostate tumors.
This study showed no association between baldness at age 45 and prostate cancer risk, overall or for clinical or molecular markers. The association between baldness and overall prostate cancer among younger men is intriguing, but caution is warranted when interpreting this finding.
The null findings from this large cohort study, together with previous literature's inconclusive findings across baldness patterns, suggest that baldness is not a consistent biomarker for prostate cancer risk or progression.
男性型脱发与前列腺癌之间的关联一直存在争议。我们前瞻性地研究了 45 岁时的脱发与健康专业人员随访研究（HPFS）中前列腺癌风险之间的关联，重点关注临床和分子标志物。
在诊断前，1992 年的问卷使用改良的 Norwood-Hamilton 量表进行自我报告的脱发情况。我们估计了 36760 名男性中脱发与前列腺癌风险之间的 HR，随访时间至 2014 年。我们还研究了脱发是否与雄激素受体肿瘤蛋白表达和 TMPRSS2:ERG 融合存在定义的前列腺癌有关。
在 22 年的时间里，发现了 5157 例前列腺癌病例。60%的男性有额部或顶部脱发。脱发与前列腺癌风险之间没有显著关联。在年龄小于 60 岁的男性中，额部和严重顶部脱发与总体前列腺癌之间存在统计学上显著的关联（HR：1.74；95%置信区间：1.23-2.48）。脱发与前列腺肿瘤的 AR 和 TMPRSS2:ERG IHC 定义的分子亚型的表达没有显著关联。
这项研究表明，45 岁时的脱发与前列腺癌风险之间没有关联，无论是整体风险还是临床或分子标志物。在年轻男性中，脱发与总体前列腺癌之间的关联令人好奇，但在解释这一发现时应谨慎。
这项大型队列研究的阴性结果，以及以前文献中脱发模式的不确定结果，表明脱发不是前列腺癌风险或进展的一致生物标志物。
