Figure 1 - uploaded by Rodney Daniel Sinclair
Content may be subject to copyright.
Pattern of androgenetic alopecia according to a modified Hamilton–Norwood scale, used by participants to score androgenetic alopecia at ages 20 and 40 years. Adapted from Norwood (21) with permission of Wolters Kluwer Health.  

Pattern of androgenetic alopecia according to a modified Hamilton–Norwood scale, used by participants to score androgenetic alopecia at ages 20 and 40 years. Adapted from Norwood (21) with permission of Wolters Kluwer Health.  

Source publication
Article
Full-text available
Background: Both prostate cancer and androgenetic alopecia are strongly age-related conditions that are considered to be androgen dependent, but studies of the relationship between them have yielded inconsistent results. We aimed to assess whether androgenetic alopecia at ages 20 and 40 years are associated with risk of prostate cancer. Methods: At...

Context in source publication

Context 1
... the face-to-face follow-up interview, men were asked to assess their androgenetic alopecia according to a set of pictures adapted from the Hamilton-Norwood scale ( Fig. 1; refs. 20, 21). Men identified which of the 8 images most closely corresponded to their hair patterning at ages 20 and 40 years. At age 40 years, we classified men into 3 groups: no androgenetic alopecia (Hamilton-Nor- wood scale I or II), frontal androgenetic alopecia (Hamil- ton-Norwood scale III), and vertex androgenetic alopecia ...

Similar publications

Article
Full-text available
Androgenetic alopecia is the most common type of alopecia in both women and men. Although there are clear clinical differences between its male and female patterns, there are physiopathogenic peculiarities in each gender. Changes in the hair cycle, with the shortening of the anagen phase, is responsible for the miniaturization process, transforming...

Citations

... Findings from cohort studies have also been mixed, with results differing for aggressive versus overall prostate cancer, and patterns of baldness (any, frontal, or vertex (baldness at the crown of the head)). Two studies found an increased risk of aggressive or fatal prostate cancer [11,12], and one showed an increased risk for early-onset (before age 40 years) prostate cancer [13], comparing any or, frontal plus vertex baldness, to no baldness. ...
... Previous studies on this subject have yielded conflicting results [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]27]. A 2018 metaanalysis of eleven studies found no association between male pattern baldness and overall prostate cancer risk; however, among the five case-control studies with information on more aggressive disease, there was a 60% increased risk of aggressive prostate cancer, comparing any baldness to no baldness [17]. ...
... In our study of over 5,000 prostate cancer cases, including 780 advanced, we did not find any associations between hair patterns and advanced, lethal or high grade prostate cancer. The sample demographics in previous studies [11][12][13]15] were similar to ours, and included mainly white men of similar age distribution. However, the number of prostate cancer cases in our study (5,157) was significantly more than the previous studies. ...
Article
Background: 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. Methods: Baldness was self-reported on the 1992 questionnaire using the modified Norwood-Hamilton scale prior to diagnosis. We estimated hazard ratios 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 (AR) and the presence of the TMPRSS2:ERG fusion. Results: 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% CI:1.23-2.48). Baldness was not significantly associated with expression of molecular subtypes defined by AR and TMPRSS2:ERG immunohistochemistry of prostate tumors. Conclusion: 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. Impact: 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.
... The detailed process of literature search is shown in Fig. 1. A total of 15 eligible studies [6][7][8][16][17][18][19][20][21][22][23][24][25][26][27] were finally included in the present meta-analysis. These studies were carried out in the following geographical regions: Europe (n = 5), North America (n = 8), and Oceania (n = 2). ...
... Next, we performed stratified analyses according to various study characteristics (Table 2). When stratified analysis by geographi- Zeigler-Johnson et al [7] 2013 USA Case-control 219 318 33-93 Age 5 Thomas et al [23] 2013 USA Case-control 312 167 62.4 Age, race, family history, and BMI 5 Muller et al [22] 2013 Australia Cohort 9448 476 27-81 Age and country of birth 8 Yassa et al [21] 2011 France Case-control 281 388 67.2 Age 5 Wright et al [20] 2010 USA Case-control 942 999 35-74 Age, race, PSA screening, family history, BMI, and finasteride use 7 Cremers et al [19] 2010 Netherlands Case-control 2160 938 NA Age and family history 6 Faydaci et al [27] 2008 Turkey Case-control 108 44 50-75 Age 5 Giles et al [8] 2002 [17] 1999 Greece Case-control 246 320 NA Age, height, BMI, and years of schooling 5 Demark-Wahnefried et al [16] 1997 ...
Article
Full-text available
Background: The relationship between male pattern baldness and incidence of prostate cancer remains inconclusive. Hence, we performed the present meta-analysis based on all eligible cohort and case-control studies. Methods: A comprehensive literature search was performed in October 2017 based on PubMed and Web of Science databases. Pooled relative risk (RR) and its 95% confidence interval (95% CI) was calculated with a DerSimonian and Laird random-effects model. Results: A total of 15 studies were included in this meta-analysis. Overall, no statistically significant association between baldness (any pattern) and prostate cancer risk was identified (RR: 1.03, 95% CI 0.96-1.11). There was obvious heterogeneity across included studies (P < .078 for heterogeneity, I = 36.4%). When subgroup analysis by types of baldness, a statistically significant association was observed for vertex baldness (RR 1.24, 95% CI 1.05-1.46) but not for other types of baldness. Conclusion: Individuals with vertex baldness may have an increased risk of prostate cancer. Given the obvious heterogeneity and null results in overall analysis and most of subgroup analyses, further large well-designed prospective cohort studies are warranted to confirm our preliminary findings.
... Few previous reports have sought associations between AA and prostate cancer. Even the suggested association between androgenic alopecia and prostate cancer remains unclear [20][21][22][23] . However, androgen levels is suggested influence the pathogenesis of prostate cancer 24 . ...
Article
Full-text available
The cancer risk in patients with alopecia areata (AA) or alopecia totalis (AT)/alopecia universalis (AU) remains unknown. In this study, national statistical data were used to study the association between these forms of alopecia and the risk of cancer. We enrolled 668,604 patients who were treated for alopecia from 2007 to 2014, and age- and sex-matched control subjects. AA and AT/AU patients had slightly higher overall cancer risks (hazard ratio (HR), 1.043; 95% confidence interval (CI), 1.022-1.065 and HR, 1.07; 95% CI, 1.013-1.129, respectively) than controls, after adjusting for confounding factors. The risks of oral cavity, esophagus, liver, biliary tract, pancreas, larynx, lung, kidney, breast, cervix, ovary, uterus, testis, nerve, and skin cancers; and lymphoma, multiple myeloma, and leukemia, were not increased in alopecia patients. In AA or AT/AU patients, the only increased risk was that of thyroid cancer. In AA patients alone, the risks of bladder and prostate cancers were increased. Thus, the cancer risks varied by the alopecia subtype. Careful monitoring is needed to explore if the actual risks of thyroid, bladder, and prostate cancers are increased in alopecia patients.
... The literature retrieval identified 1562 records in Pubmed and 4476 in Embase. Ultimately, 20 publications [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] were finally selected for the study; the flow diagram was presented in Fig. 1. The results of methodological quality assessment indicated that all included records were of high quality (More details were shown in Additional file 3: Table S2 and Table S3). ...
... In total, six cohort studies [17,18,20,23,24,27] and 14 case-control studies [19,21,22,25,26,[28][29][30][31][32][33][34][35][36] were included in the present systematic review and metaanalysis. Among these, two cohort studies [17,18,37] were conducted on PC-specific mortality. ...
... P = 0.071). Twenty observational studies were involved in assessing the relationship between AGA and cancer incidence, including 6 cohort studies [17,18,20,23,24,27] and 14 case-control studies [19,21,22,25,26,[28][29][30][31][32][33][34][35][36]. The cohort study of Hawk et al. [27] with the effects estimated by RRs was combined with case-control studies in the pooled analyses. ...
Article
Full-text available
Background: A number of studies have investigated the association between androgenic alopecia (AGA) and cancer risk, but they have yielded inconsistent results. Therefore, this study was conducted to explore this controversial subject. Methods: A literature database search was performed according to predefined criteria. An odds ratio (OR) or a hazard ratio (HR) with 95% confidence intervals (CIs) was retained to evaluate the relationship between the incidence of cancer or cancer-specific mortality and categories of AGA. Then a pooled OR or HR was derived. Results: The pooled results showed that no specific degree of baldness had an influence on the incidence of cancer or cancer-specific mortality. However, AGA, especially frontal baldness, with the incidence of testicular germ cell tumor (TGCT) (OR = 0.69; 95% CI = 0.58-0.83). A significant increase of risk was observed in relation to high grade prostate cancer (PC) (OR = 1.42; 95% CI 1.02-1.99) and vertex with/without frontal baldness was associated with PC risk. Conclusions: The study results supported the hypothesis that AGA is negatively associated with TGCT risk and suggested an overlapping pathophysiological mechanism between them, while the viewpoint that AGA can be used as a phenotypic marker for PC risk was poorly supported.
... Our earlier case-control study of total PC reported that men with early-onset AA, i.e. age 40 years and prior, were at greater risk of subsequent prostate cancer and that this develops at an earlier age [7,8]. This finding was corroborated by subsequent cohort and case-control studies showing an increased risk of developing aggressive prostate cancer (APC) associated with AA [9][10][11][12][13]. ...
... As this study was undertaken prior to the revision of the Gleason grading system, it is likely many of the men classed as moderate grade would now fall into the highgrade category [25,26]. In our cohort study [7], we reported that vertex balding at age 40 years resulted in a hazard of PC that was non-proportional, with bald men likelier to develop PC at younger age [hazard ratio (HR) at 55 years = 1.81, 95% CI 1.13-2.90) decreasing to significantly below unity by age 75 (HR 0.44, 95% CI 0.33-0.95). ...
... It is possible that the sample of our study differs from that of men with APC in the population with respect to some of the covariates used in the analysis. A bias report from the VCR indicated a very similar distribution of residence location between participants and all men with PC in the state and the proportion of balding men in our sample is similar to a much larger cohort study undertaken previously by our centres [7]. While it is the experience of the practicing urologist authors that men presenting to clinics in the state do not differ appreciably with respect to socioeconomic or other demographic factors, selection bias cannot be ruled out. ...
Article
Full-text available
Purpose: We aimed to evaluate the associations between androgenetic alopecia at a young age and subsequent development of aggressive prostate cancer (PC). Methods: Using a case-control design with self-administered questionnaire, we evaluated the association between aggressive PC and very early-onset balding at age 20, and early-onset balding at age 40 years in 1,941 men. Cases were men with high-grade and/or advanced stage cancer and controls were clinic based men who had undergone biopsy and were found to be histologically cancer negative. Additionally, for cases we assessed whether early-onset balding was associated with earlier onset of disease. Results: Men with very early-onset balding at age 20 years were at increased risk for subsequent aggressive PC [odds ratio (OR) 1.51, 95% confidence interval (CI) 1.07-2.12] after adjustment for age at baseline, family history of PC, smoking status, alcohol intake, body shape, timing of growth spurt and ejaculatory frequency. Additionally, these men were diagnosed with PC approximately 16 months earlier than cases without the exposure. The effect was present particularly for men with advanced stage pT3+ disease (OR 1.68, 95% CI 1.14-2.47) while men with organ-confined high-grade (8-10) PC did not exhibit the same relationship. No significant associations were observed for men who were balding at age 40 years, given no balding at age 20. Conclusion: Men with androgenetic alopecia at age 20 years are at increased risk of advanced stage PC. This small subset of men are potentially candidates for earlier screening and urological follow-up.
... Male androgenetic alopecia (AGA) is the most common type of hair loss in men. It accounts for more than 90% of all cases of alopecia in men (1) . It occurs when genetically predisposed men are exposed to androgens. ...
Article
Introduction: Male androgenetic alopecia (AGA) is the most common type of hair loss in men. It accounts for more than 90% of all cases of alopecia in men . It occurs when genetically predisposed men are exposed to androgens. AGA may negatively affect patient's quality of life and can lead to social and job-related problems. AGA can also cause indirect physical harm, such as sunburn as a result of hair loss and exposure to ultraviolet light . AGA may also be associated with increased incidence of hypertension, hypercholesterolemia, and myocardial infarction . The only FDA approved therapies for treatment are limited to topical minoxidil and oral FIN with limited efficacy (40-60%), As multiple factors are implicated in the pathogenesis of AGA and the existing conventional therapies (i.e. FIN and minoxidil) fail to target all of them; the demand for new treatment techniques for AGA is growing . Dutasteride (DST) is a dual Sa-recluctase inhibitor, with some reports about the use of oral DST in the treatment of AGA in men, Hesitancy about the widespread use of oral DST in the treatment of male AGA results from its potential side effects on erectile, ejaculatory functions and fertility . Mesotherapy using DST has been used in patients with AGA with promising results . It is believed that systemic absorption after mesotherapy is equal to after oral DST because the scalp is highly vascular. So the possibility of using DST topically with scalp MN would have some advantages . Microneedling (MN) is a relatively new minimally invasive procedure involving superficial and controlled puncturing of the skin by rolling with miniature fine needles . The use of MN in combination with minoxidil showed promising results in treatment of AGA. Furthermore; the addition of MN to minoxidil and oral FIN improved AGA in patients who were resistant to minoxidil and oral FIN .. To the best of our knowledge; the use of MN in combination with DST hasn't been previously reported. This study was designed to evaluate the efficacy and safety of topical DST with MN in treatment of male AGA.
... It has been hypothesised that pigmentation-related traits may influence prostate cancer risk, possibly through altered vitamin D synthesis, owing to a finding in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study that men with naturally red hair (which is determined by polymorphisms in the melanocortin-1-receptor (MC1R) gene) had a lower risk of prostate cancer compared to men with light brown hair (Weinstein et al, 2013); however, no significant association between naturally red hair and prostate cancer risk was observed in the current study. Because of the influence of the active androgen dihydrotestosterone on both the growth of prostate cells and on androgenic alopecia, malepattern balding has also been suggested as possible risk factor for prostate cancer, although the findings are inconclusive (Muller et al, 2013;Zhou et al, 2015a, b;Sarre et al, 2016) and the current study found no association between balding pattern and prostate cancer risk. ...
Article
Full-text available
Background: Prostate cancer is the most common cancer in British men but its aetiology is not well understood. We aimed to identify risk factors for prostate cancer in British males. Methods: We studied 219 335 men from the UK Biobank study who were free from cancer at baseline. Exposure data were collected at recruitment. Prostate cancer risk by the different exposures was estimated using multivariable-adjusted Cox proportional hazards models. Results: In all, 4575 incident cases of prostate cancer occurred during 5.6 years of follow-up. Prostate cancer risk was positively associated with the following: black ethnicity (hazard ratio black vs white=2.61, 95% confidence interval=2.10-3.24); having ever had a prostate-specific antigen test (1.31, 1.23-1.40); being diagnosed with an enlarged prostate (1.54, 1.38-1.71); and having a family history of prostate cancer (1.94, 1.77-2.13). Conversely, Asian ethnicity (Asian vs white hazard ratio=0.62, 0.47-0.83), excess adiposity (body mass index (⩾35 vs <25 kg m(-2)=0.75, 0.64-0.88) and body fat (⩾30.1 vs <20.5%=0.81, 0.73-0.89)), cigarette smoking (current vs never smokers=0.85, 0.77-0.95), having diabetes (0.70, 0.62-0.80), and never having had children (0.89, 0.81-0.97) or sexual intercourse (0.53, 0.33-0.84) were related to a lower risk. Conclusions: In this new large British prospective study, we identified associations with already-established, putative and possible novel risk factors for being diagnosed with prostate cancer. Future research will examine associations by tumour characteristics.British Journal of Cancer advance online publication 14 September 2017; doi:10.1038/bjc.2017.312 www.bjcancer.com.
... AGA has been reported to be associated with several diseases such as coronary heart disease, hypertension, obesity, benign prostatic hyperplasia and prostate cancer. Although these associations have not been validated, the comorbidities underscore the value of uncovering the molecular basis of AGA [21][22][23][24][25]. ...
... AGA has been reported to be associated with several diseases such as coronary heart disease, hypertension, obesity, benign prostatic hyperplasia and prostate cancer. Although these associations have not been validated, the comorbidities underscore the value of uncovering the molecular basis of AGA [21][22][23][24][25]. ...
... 25 The Melbourne Collaborative Cohort Study (MCCS) showed that men with vertex balding at age 40 years had a higher risk of early onset PC, but a lower risk of late onset PC, compared with men without vertex balding at 40 years of age; risk of PC was similar for men with and without vertex balding between ages 60 and 70 years, suggesting that it is important to report age of balding when addressing its effect on PC risk. 26 The lack of such an association in our study, may partly be explained by the absence of information on age of onset for balding which we did not collect. PC development is strongly associated with alterations in androgen metabolism and production of DHT, the active metabolite of testosterone. ...
Article
Prostate cancer (PC) is the most common non-cutaneous cancer in men worldwide. The relationships between PC and possible risk factors for PC cases (n=1181) and male controls (n=875) from the New South Wales (NSW) Cancer, Lifestyle and Evaluation of Risk Study (CLEAR) were examined in this study. The associations between PC risk and paternal history of PC, body mass index (BMI), medical conditions, sexual behaviour, balding pattern and puberty, after adjusting for age, income, region of birth, place of residence, and PSA testing, were examined. Adjusted risk of PC was higher for men with a paternal history of PC (OR=2.31; 95%CI: 1.70-3.14), personal history of prostatitis (OR=2.30; 95%CI: 1.44-3.70), benign prostatic hyperplasia (OR=2.29; 95%CI: 1.79-2.93), being overweight (vs. normal; OR=1.24; 95%CI: 0.99-1.55) or obese (vs. normal; OR=1.44; 95%CI: 1.09-1.89), having reported more than 7 sexual partners in a lifetime (vs. < 3 partners; OR=2.00; 95%CI: 1.49-2.68), and having reported more than 5 orgasms a month prior to PC diagnosis (vs. ≤3 orgasms; OR=1.59; 95%CI: 1.18-2.15). PC risk was lower for men whose timing of puberty was later than their peers (vs. same as peers; OR=0.75; 95%CI: 0.59-0.97), and a smaller risk reduction of was observed in men whose timing of puberty was earlier than their peers (vs. same as peers; OR=0.85; 95%CI: 0.61-1.17). No associations were found between PC risk and vertex balding, erectile function, acne, circumcision, vasectomy, asthma or diabetes. These results support a role for adult body size, sexual activity and adolescent sexual development in PC development. This article is protected by copyright. All rights reserved.