MedWire News: Men with prostate cancer are twice as likely to have started losing their hair by the age of 20 years compared with men without the disease, reports a French research team.

The study results indicate a possible link between early-onset androgenic alopecia and the development of prostate cancer, say the researchers who found no link between hair loss and severity of cancer or age at diagnosis, or hair loss patterns and overall prostate cancer risk.

"We need a way of identifying those men who are at high risk of developing the disease and who could be targeted for screening and also considered for chemo-prevention using anti-androgenic drugs such as finasteride," said Philippe Giraud (European Georges Pompidou Hospital, Paris).

Finasteride, a type II 5-alpha reductase inhibitor that blocks the conversion of testosterone to dihydrotestosterone, is used for the treatment of androgenic alopecia and has been shown to decrease the incidence of prostate cancer, explain Giraud and team in the Annals of Oncology.

The team age-matched 388 men with an average age of 67 years and a history of prostate cancer with 281 men with no history of the disease (controls). The men completed a questionnaire asking them to "stage" their hair loss at ages 20, 30, and 40 years, with stage I representing no balding, and stage IV representing both frontal and vertex balding.

After controlling for age and family history of baldness and prostate cancer, any balding (stage II-IV) present at age 20 years was associated with an increased prostate cancer risk. Specifically, compared with controls, men with prostate cancer were 2.01 times more likely to have had signs of alopecia at 20 years of age.

In contrast, patterns of hair loss (frontal, vertex, or both) did not predict prostate cancer development, and by the age of 30 years, any presence of vertex alopecia, either alone or with frontal alopecia, had lost the association with prostate cancer.

"Balding at the age of 20 may be one of those easily identifiable [prostate cancer] risk factors and more work needs to be done now to confirm this," Giraud concluded.

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