MP Birch, JCRBowling, AG Messenger
Departments of Dermatology, Royal Hallamshire Hospital Sheffield
The Middlesex Hospital, London, UK
During recruitment for a clinical trial of a treatment for androgenetic alopecia in young men, two out of 30 men wishing to enrol in the trial gave a history of testicular cancer. We therefore carried out an observational study to examine the association between male androgenetic alopecia and testicular cancer in more detail. We examined 144 patients with a diagnosis of testicular cancer attending an oncology clinic.
They were classified by: histological diagnosis (68 teratoma, 73 seminoma, 2 mixed seminoma/teratoma and 1 leydig cell), age, treatment received, and hair status (Norwood-Hamilton Scale). Hair status was assessed by two observers and compared with a database of 558 healthy males drawn from the local population and in whom hair status had been evaluated by the same observers. Hair loss was classified as nil (Norwood Hamilton grades I and II), mild (grades IIv, III, IIIa, IIIv), moderate (grades IV and V) and severe (grades VI and VII).
There was a significant increase in mild hair loss in men with seminoma (52%) compared with controls (25%) whether adjusted (p<0.01, confidence interval 1.97-7.44; Mantel-Haenszel test) or unadjusted (p<0.01, CI 1.57-5.74) for age. There was a significant increase in mild hair loss in men with teratoma (38%) compared with controls (25%) when adjusted (p<0.01, CI 1.23-4.88) for age, however this was not significant when unadjusted for age (p=0.25, CI 0.76 – 2.52).
The causes of testicular cancer are unknown but genetic factors, cryptorchidism, exposure to maternal hormones in utero and exposure to other environmental hormones have all been implicated. Our results indicate that balding tends to occur earlier in men predisposed to seminoma suggesting that similar genetic or environmental factors underlie both conditions.