Possible association between androgenic alopecia and risk of prostate cancer and testicular germ cell tumor: a systematic review and meta-analysis

Abstract

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.

Keywords: Androgenic alopecia; Association; Meta-analysis; Prostate cancer; Risk; Testicular germ cell tumor.

Fig. 1

Flow diagram of included studies for this meta-analysis

Fig. 2

Forest plots of any AGA and the risk of PC and TGCT incidence for case-control studies: a for TGCT incidence; b for PC incidence; and c high grade PC incidence

Fig. 3

Begg’s funnel plots for publication bias of the relative risk of cancer incidence: a for all included studies; b for case-control studies; and c for cohorts