Background: Male pattern baldness (androgenic alopecia) has been associated with scalp skin cancer in case-control studies. A potential androgen basis of melanoma has been hypothesized and baldness has been associated with higher levels of androgens. We examined the association between male pattern baldness and risk of skin cancer, including melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC) in a prospective cohort study.

Methods: We included 36,032 participants from the Health Professionals’ Follow-up Study. In 1992, participants reported their status of male-pattern baldness at age 45 years by choosing from five crown-view pictograms based on Norwood's classification. Diagnosis of skin cancers was reported in the self-reported questionnaires biennially and report on melanoma and SCC was pathologically confirmed. Cox proportional hazard models were used to compute the hazard ratios (HR) and 95% confidence intervals (CI).

Results: We identified 327 cases of melanoma, 1324 cases of SCC, and 8438 cases of BCC during the follow-up. Male-pattern baldness at age 45 was not associated with risk of incident melanoma, but was significantly associated with increased risk of both SCC and BCC. The multivariate-adjusted HR (95% CI) for the highest category of baldness (frontal plus severe vertex baldness) was 1.33 (1.06-1.68) for SCC (Ptrend = 0.001) and 1.23 (1.12-1.35) for BCC (Ptrend<0.0001), compared with no baldness. Analyses by body sites of tumors found significant associations between frontal plus moderate to severe vertex baldness and risk of melanoma (HR = 1.83, 95% CI: 1.01-3.34) and SCC (HR = 1.30, 95% CI: 1.02-1.66) at head and neck. The associations were particularly stronger for scalp melanoma (HR = 7.15, 95% CI: 1.29-39.42) and scalp SCC (HR = 7.09, 95% CI: 3.84-13.08), but not for non-scalp head and neck sites.

Conclusion: Male pattern baldness was positively associated with increased risk of skin cancer. The associations may only exist for skin cancer at head and neck, particularly those occurring at scalp.

Citation Format: Wen-Qing Li, Eunyoung Cho, Jiali Han, Martin Weinstock, Abrar Qureshi. Male pattern baldness and risk of incident skin cancer in a cohort of men. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1757.