Relationship between male pattern baldness and the risk of aggressive prostate cancer: an analysis of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial.
Relationship between male pattern baldness and the risk of aggressive prostate cancer: an analysis of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial.
复制标题
DOI：
10.1200/jco.2014.55.4279
复制
发表时间：
2015-02
期刊：
影响因子：
--
通讯作者：
C. Zhou;R. Pfeiffer;S. Cleary;H. Hoffman;P. Levine;L. Chu;A. Hsing;M. Cook
中科院分区：
文献类型：
--
作者：
C. Zhou;R. Pfeiffer;S. Cleary;H. Hoffman;P. Levine;L. Chu;A. Hsing;M. Cook
男性型秃发和前列腺癌似乎有共同的病理生理机制。然而，以前评估它们之间关系的研究结果并不一致。因此，我们在一项大型前瞻性队列-前列腺、肺、结直肠和卵巢（PLCO）癌筛查试验中调查了45岁男性型脱发与前列腺癌总体和亚型风险的相关性。我们纳入了来自试验队列常规护理和筛查组的39，070名男性，他们在随访开始时没有癌症诊断（不包括非黑色素瘤皮肤癌），并回忆了他们45岁时的脱发模式。使用考克斯比例风险回归模型，以年龄作为时间指标，估计风险比（HR）和95% CI。结果：在随访期间（中位数，2.78年），1,138例前列腺癌病例被诊断，其中571例为侵袭性（活检Gleason评分≥ 7，和/或临床III期或更高，和/或致命）。与无秃顶相比，45岁时前额加中度头顶秃顶与总体脱发无显著相关性。（HR，1.19; 95% CI，0.98 - 1.45）或非侵袭性（HR，0.97; 95% CI，0.72 - 1.30）前列腺癌风险，但与侵袭性前列腺癌风险增加显著相关（HR，1.39; 95% CI，1.07至1.80）。协变量的调整并未实质性改变这些估计值。其他类型的脱发与前列腺癌的总体或亚型无显著相关性。结论：我们的分析表明，45岁时前额加中度头顶秃顶与侵袭性前列腺癌风险增加相关，并支持共同病理生理机制的可能性。
PURPOSE Male pattern baldness and prostate cancer appear to share common pathophysiologic mechanisms. However, results from previous studies that assess their relationship have been inconsistent. Therefore, we investigated the association of male pattern baldness at age 45 years with risks of overall and subtypes of prostate cancer in a large, prospective cohort—the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. METHODS We included 39,070 men from the usual care and screening arms of the trial cohort who had no cancer diagnosis (excluding nonmelanoma skin cancer) at the start of follow-up and recalled their hair-loss patterns at age 45 years. Hazard ratios (HRs) and 95% CIs were estimated by using Cox proportional hazards regression models with age as the time metric. RESULTS During follow-up (median, 2.78 years), 1,138 incident prostate cancer cases were diagnosed, 571 of which were aggressive (biopsy Gleason score ≥ 7, and/or clinical stage III or greater, and/or fatal). Compared with no baldness, frontal plus moderate vertex baldness at age 45 years was not significantly associated with overall (HR, 1.19; 95% CI, 0.98 to 1.45) or nonaggressive (HR, 0.97; 95% CI, 0.72 to 1.30) prostate cancer risk but was significantly associated with increased risk of aggressive prostate cancer (HR, 1.39; 95% CI, 1.07 to 1.80). Adjustment for covariates did not substantially alter these estimates. Other classes of baldness were not significantly associated with overall or subtypes of prostate cancer. CONCLUSION Our analysis indicates that frontal plus moderate vertex baldness at age 45 years is associated with an increased risk of aggressive prostate cancer and supports the possibility of common pathophysiologic mechanisms.